PBIRJV RTI. WOI5 in Pqj&TO RICO

PUBLIC HEALTH REPORTS

VOL.XXVM. DECEMBER 12, 1913. No. 50.

PBIRJV RTI. WOI5 IN PQj&TO RICO. A OF I=WNOWK or MJNWI''l I WOPICAL M _DW AND TGYW4 0P 1PORTO 0ICO, By W. W. K1r, Surgeon, United States Public Health Service. The following is a report of the work in which I have been engaged, as a member of the Institute of Tropical Medicine and Hygiene of Porto Rico, from the beginning of my connection with it until October 31, 1913. For the better understanding of the inustitute and its purposes I shall give the following synopsis of its orgAnization and history: It was organzed uuder the provisions of an act of the Legislative Assembly of Porto Rico, dated March 13, 1913. It was planned and organized by Maj. Bailey K. Ashford, Medical Corps, United States Army; Dr. W.F. Lippitt, director of sanitation of Porto Rico; Dr. Pedro Gutierrez Igaravidez, of San Juan; and Dr. Isaac Gonzalez Martinez, director of the biolo_gical laboratory, service of sanitation of Porto Rico. Dr. Francisco Hernandez was selected for secretary of the institute. Dr. Lippitt, as director of sanitation, is ex officio administrator .of its funds. Inasmuch as he and Dr. Hernandez can not take an active part in the scientific work of the institute, a purely technical commission was selected for that purpose consisting of the other members and Maj. Ashford. Mai. ahford is not a men4er of the institute, but has been detailed by tbhp Surgeon General of the Army as a board, consisting of -one member, "for the study of tropical diseases as they exist in Porto Rico." He decided to work in conjunction with the technical com- mnission and was elected a member of that commission by the other member. Dr. khford and the writer are not at all concerned with the administration of the institute, but co fine themselves entirely to the scientific w-ork of the technical conzission. At the policitation of the members of the institute, the governor of Porto Rico requested the Surgeon General of the Public Health Service to detail me as a member of the institute. In order to carry out thi4 request, I was detailed as chief quarantine officer of Porto Rico and lter as member of the institute. I arrived in Porto Rico September 4, but was too occupied with quarxtine matters to do any work wit),h jthe iWitute until the 10th of October, when J *oWed the ow wlpaxerp at UJtuado,, whexp eadquarters had beon established for the xpeditionry work in the mountains. 190 (2681) December 12,1913 .2682 The plan of the institute work has three distinct periods: 1. Three months of teaching, instruction of sanitary officials, inspectors, etc. 2. Three months of expeditionary work in the interior mountainous districts. 3. Six months of research work at the laboratory and hospital at San Juan. Study and examination of data and specimens collected during the expedition. The permanent headquarters of the institute is located in San Juan in a new two-story cement building fronting the bay. On the adjoining grounds are 10 small cement isolation buildings of two rooms each. They were built for a quarantine hospital, but have practically been turned over to the institute by the director of sanitation. Near by is located the excellent laboratory of the sanitation service,which has also been put at the disposal of the institute by its director, who is a member of the institute. The use of these buildings and laboratory equipment will be without expense to the institute except for a share of the running expenses of the hospital. The appropriation for the institute was $20,000, which will be expended chiefly in experimental work, hospital expenses, expedition expenses, purchase of medical and other supplies, and salaries. I do not receive any salary, but will receive reimbursement for expense when traveling on business of the institute. The first three months were devoted, according to plan, to teaching. Instruction was given to 60 students selected from among the corps of sanitary inspectors of the sanitation service. It was designed not only to instruct these officials in the knowledge pertaining to their particular work, but also to determine those who were unfit for the position they occupied. It is intended by the director of sanitation to make this annual course the basis of appointment of these officials in the future. Lectures were given by Maj. Ashford on hygiene and preventive medicine, Dr. Gutierrez on epidemiology and disinfection, Dr. Gon- zalez on bacteriology and zoology, and the director of sanitationi detailed various officials of his department to lecture on sanitary engineering, veterinary inspection, chemistry, food inspection, administration and accounting, vital statistics, and sanitary laws and regulations. There is in preparation a manual in Spanish for the use of these nonmedical inspectors, the various instructors contributing chapters on their special subjects. In preparation for the three months expedition, lists of medical and surgical supplies were carefully prepared gnd ordered from the United States. Slow deliveries from some firms delayed the start of the expedition. 2683 December 12, 1913 This expedition had three aims: 1. Study of the diseases prevailing in the interior. 2. FEtablishment of a rural ambulant medical service. 3. Education of both planter and peon in elementary hygiene and sanitation. In the fist place, there are undoubtedly many tropical and other diseases occurring more or less frequently in Porto Rico but which while known to exist in other places- have never been identified in Porto Rico. There are others such as schistosomiasis, sprue, etc., which present many unsolved problems of interest and importance. Research along these lines is one of the prime objects of the institute. The second object is one of immense importance to Porto Rico. The rural population of Porto Rico, according to the census of 1910, was 79.9 per cent of the whole. Of these it is estimated by various observers that from 50 to 70 per cent are in need of medical attention. To meet this condition there is only the municipal physician with a very small appropriation at his command. Municipal physicians seldom make visits to the sick poor in the country. Hence the custom has arisen that if medical attention is desired, another member of the family or a friend sees the doctor in town, details,the symptoms as best he can, and carries back what medicine is prescribed to fit the apparent necessities of the patient. Sometimes the sick person is caxried long distances over mountain paths in a hammock to town, and it not infrequently happens that he must be carried home again because the hospital is already crowded. Only a few of the larger cities have good hospitals, most of them being small and poorly equipped. Under these circumstances it results that the greater part of the rural population rely upon home remedies or upon the ministrations of some person in the neighborhood who has acquired-a reputation for treating the sick. Following the work of the anemia commission (Ashford, Gutierrez, and myself) in 1904 and 1905, the insular Government has continued the appropriations for the support of the anemia service, with the result that until the present time about 300,000 persons have been treated. The dispensaries of the anemia service are located in the towns, and the same objection holds against them-that they can not reach the remoter districts of the municipalities. It is to these out-of-the-way places that the ambulant rural service will carry iedical relief. In the third place, the expedition proposes to show both planter and peon their sanitary errors, and what can be done to correct them and how to protect tl,emselves as much as possible from the communicable diseases to which they are -exposed. The enforcement of sanitary laws and- regulations is almost impossible until there is some December 12, 1913 2a9 general understanding of hygiene and sanitation, and some inAerest in their application. It was determined to establish 1he-expedition at some point in the mountains of the interior, to locate there a large out-patient clinic and a small hospital, and a clinical laboratory. From this eenter subclinics will be established in certain localities where a number of plantations are conveniently grouped. The equipment of the expedition consists of- 1. A portable clinical Iaboratory. 2. A large stock of drugs, mostly in tablets, instruments, and dressings. 3. A 30-bed hospital. 4. Horses and pack mules, portable medicine cases, and oases of instruments, etc. The site selected is about 1 mile from Utuado, at the coffee and sugar plantation known as San Andres. In the large country house are located thelaboratory, dispensary, examinationrooms, and quarters for the members of the technieal commission and its assistants. A two-story servant's'building was converte into the hospital-men's ward on the ground floor and women's ward on the seond floor. The location is central to a large municipality of some 40JOOO souls, and can be reached in al directions by roads and trails. Inasmuch as the material for study and research must be culled from a large number of paeients, it was very evident that some means -must be taken to attract them in large -numbers. Nothing couldserve this purpose as the opening of an "anemia station" for-the treatment of uncinariasis, more especially as this is the place where in 1904 the anemia commission inaugurated its campaign and where there is yet a lively remembrance of the benefits of treatment for this disease. The distict is still heavily infected in spite of the large number of persons who have been treated, and it was known that the opening of an anemia dispensary would -bring a great number of petients. The director of sanitation put under the control of the institute four ambulant anemia dispensaries provided for -by the As Foorto Rican ILegislature, thus giving the institute the means of handling the anemia patients. These dispensaries, for the time being com- bined, bring to the institute four young physicians, graduates of American medical coleges, who have shown themselves to'be active and capable young men. They will in the near future take the field as the first of the ambulant medical service above mentioned. The traiming which they are receiving looks to that end. One of them acts also in the capacity of official representative of the administrator of the institute. The technical commission established themselves at 1te selected place on September 15 and for a week were occupied in unpacking 26i85 December 1'2, 1913 and arrangi supplies, making necessary changes in buildings, fitting up the hospita4 laboratory, etc. Treatment of patients was begun on September 23. The personnel of the expedition at that time consisted of: Maj. Bailey K. Asbaord, Dr. Pedro Gutierrez Igaravidez, Dr. Isaac Gon- zalez Martinez, members of the technical commission; Dr. Pedro Malaret, jr., representative of administrator; Dr. Federico Trilla, Dr. Bernabe, assistants to the commiion and physicians of the anemia service; Mr. Victor Lopez Nuass, chief clerk; Mr. Artau, Mr. Her- rero, pharmacists and practicantes; one female superintendent of hospital, one graduate nurse, one stuidnt nurse, one hospital helper, one housekeeper, two cooks, one maidservant, three peons. The technical commion was later increased by the arrival of Dr. W. W. King, sirgeon, United States Public Health Service; Dr. Mestre and Dr. Arbonai (relieving Dr. Bernabe), anemia physicians; two additional pharmacists and practicantes, and several miseel- laneous employees. On aceount of urgent quarantine business at San Juan and Ponce, I was unable to join the commssion before October 10. From the opening of the clinic to October 31 there have been registered about 7,450 patients, who have made about 25,000 visits, an avwage of about 625 daily. This should be compared with the number treated here by the anemia commission in 1904 (4,490) and the nmber at Aibonito in 19(1 (6,152) during periods of 3 and 9 months, respectively. Th3 patients are formed in lines, men and women separately. Those coming for the first time are directed to the registrar's desk, wh&re they are given a small identification card (inlosed and marked "A") and a larger cliniical card (inclosed and marked "B"), both bearing the same serial number. The identification card remains in the possession of the patienkt and must be presented at each visit. It servos as his ticket of admission to the amination and by the number to find the clinical card in the file. At the registration desk the nonmedical parts of the cards are filled in and the patient passe to the lines leadig to the examination desks, where one of the anea physicians makes a microcopical examination of the feces, notes the findings on the clinical card, puts a few pertinent and comprehensive questions to the patient and fills out the medical parts of the card. A little practice enables one to do the talking with the patient while making the microscopical examination, thus saving valuable time. If the case is one of uncinariasis only, the prescription is written and the treatment noted on the card, which is then fibd. The patient then passes to the lines at the dispensing counter whe he receives his medicine and i. told how to take it. Unless there is some reason to the contrary, patients are told to return in one week. December 12, 1913 2686 It is a well-understood thing among these people that they must bring a specimen of their feces, and they seldom fail to be provided with it. As safety matches are the only kind used in Porto Rico, the empty boxes are quite plentiful and were quickly adopted by these people for the purpose of bringing the specimen. Pill boxes, and in fact all kinds of receptacles, even leaves, are used, but the "cajita" or little box has become synomymous with specimen of feces. In case the patient does not come so provided, he is given medicine to relieve his principal symptom and told that on his next visit he must bring the "cajita" if he wants medicine for permanent relief. A notation to this effect is made on his card. This part of the work is done under the portico in front of the main building, temporary palm bark extensions having been made to the roof to shelter large enough space. On one side are the examining physicians- and on the other the registration desk and dispensing counter. The lines of patients form in the yard. Uncinariasis patients at their second and third visits are sent direct to the dispensing counter where one of the anemia physicians -is on duty. He questions them as to the effect of the medicine, modifies the dose if necessary, etc., making the notation of the visit and the medicine given, on the card. At the third visit the patient is told that he must bring his specimen of feces every time thereafter until told not to do so. At the fourth and later visits he goes to the examining side again for examination of feces. This examination is omitted at the second and third visits because we found, during the work of the anemia commission at Aibonito in 1905, that three doses are generally required to expel 95 per cent of the uncinaria. Patients being treated for ascaris infection are required to have their feces examined at each visit. After treatment when the feces show no uncinaria ovum the patient is given Blaud's pills and told to bring another specimen next week. In addition to uncinariasis the anemia physician prescribes for ascariasis and many ordinary diseases and simple complaints that do not require much examination or time. Other cases are marked "special" and are sent to the members of the institute for examination and treatment. These special cases will be explained later. The members of the institute work inside the house where four rooms have been set aside as foUows: 1. A clinical laboratory. 2. An examining room. 3. A reception room. 4. A drug room and dispensary. The laboratory is well equipped for the clinical purposes for which it is intended, such as examination of urine, blood, fece, pus, and other material from patients. Most of the pathological anatomy specimens wiU be kept for study in San Jua.n. 2687 December 12, 1913 -The examination room is equipped with examining table, stethoscopes, endoscopes, msthesiometers, and other instruments of precision. Each member has a writing table on which he keeps a file of clinical cards with the data of his special cases. Operations are also done in this room for lack of a better place. The hospital is reserved for cases under observation or for those patients who are too ill to be treated in their homes. At the general clinic outside the building the physicians are instructed to send all special cases to the reception room inside the building. These are: 1. Persons who have not intestinal parasites and whose ailment requires more detailed attention. 2. Persons having intestinal parasites, who have complications or other diseases of importance. 3. Particularly those whose feces show ova of schistosomiasis, or who may be suspected to be suffering from amebiasis, malaria, skin lesions, tuberculosis, trachoma, sprue, etc. 4. Very extreme cases of uncinariasis. 5. Any person whose disease or symptoms seem to be of special interest. This is the general scheme of work of the institute at present, but on account either of lack of personnel, or extraordinary rush, the members of the institute are obliged to help out at times at the general clinic. To date the following special cases have been treated by the members of the institute: Skin diseases, various ...... 176 Venereal difaes...... 26 SchistosomiasisI (Schistosoma .nansoni) .6...... 52 Maaia... 5 Amebiasi (Amebic dyentery). 4 Pulonary tuberculosis .44 Spme .17 Splenomegaly (cause undetermined). 2 Rheumatoid arthritis. 3 Favu .1 Hypertrophy of breasts in a man of45 or 50 year. 1- Anterior poliomyelitis. 2 Cretini.. 1 Paalyis agitans ...... -.-.-.-...... 1 Acute articular rheulmatimn..e...... - 1 Pertus ...... 2 Lupus. 1

Total ...... 338 1Abolut 70 more of these cases were roeorded on the cards of the general clinc before they wre nade Special. As the patients return they are being taken up on the special cards. December 12, 1*13 268} there ire a numbe& of other cases in *hich a definite diagnosis hasf ot yet been mAde, mnd of cotsire these have tot beet incruded in thie above list. The remainder of 7a4 oases which present biily mnatters 6f minor or general interest may be elassified as follows: -Pr cent. Constitutional diseases, uch arhumatic affectiona, maasmus, etc...... 8 Disses of the digestive tract, chiefly enterocolitis and constipation...... 19 Diseaes of the respiratory tract (ose and throat, 8 per cent) ...... 22j Disase of the circulatory sytem...... 3 Diseses of the urinary tract ...... 2 Dimsbs of the blood ...... 3 Diseases of the nervous system ...... 221 Diseases of the eye (exclusive of trachoma) ...... 5 General surgery...... 7 Gynecological diseases ...... 8 There have also been recorded 42 surgical operations of all kinds and 313 laboratory examihations. The latter record by no means includes all that have been made, because in the hurry of our large clinic it has sometimes been forgotten to make the note in the record book. In the work of the technical commission special attention is at present being paid to the following diseases: &Mi8to8omta8&8.-CarefuI clinical and epidemiological notes are taken with the view of determining means of infection, intermediate host, and c'ure. At the present writing it seems rather difficult to reconcile Loos's theory of infection through the skin to conditions here. "La Bonita."-A name given by some of the country people to an affection whose chief symptom is anasarca. It svees to be lirited to the country districts and sometimes occurs epidemically. Nephri- tis is present in a large proportion of cases, and it is considered by some physicians to be an acute nephritis due to ordinary causes. It remains to be seen whether it is a disease entity or not. Sprue.-There have been a number of cases recorded from the country where it was ndt believed to exist. Ameebiagi.8 (amebic dysentery)-.-Due to the entameba histolytica. Liver abscess is rare in Porto Rico. Emetine hydrochloride has given excellent results. Malaria.-So far only two barrios (subdivisions of municipaiities) have been found infected, and the extent seems limited. One focus is of the estivo-autumnal type. Venereal disease.-Rarely found in the country districts. Most of our cases have come from towns. Uncinariais.-These cases have not yet been counted, but we estimated that at least 50 per e6nt of o&t ptients muffer from umcijariasis only. The type of the disease is milder than that which we formerly encountered here, due, we believe, to the effect of anemia work in this 2689 December 12, 1913 section. Severe cases, sometimes with less than 10 per cent hemo- globin, are, however, the commonest cause of grave illness. The people have come to realize the cause of their anemia and the result of treatment, hence the great popularity of the clinic in spite of the fact that they kndw the unpleasantness of the treatment and that at this season they come long distances to the clinic. It is now the height of cofTee picking, the one period of the year when there is plenty of work for all, yet they will take two days each week from their work for the sake of being cured-one day to come to us and the other day at home to take the medicine. Trachoma.-Its presence in Porto Rico has been well known, but there are widely divergent opinions as to its prevalence and distribution. With a view of determining these questions a series of examinations are being made. At the same time efforts are being made to bring out other facts about the disease. We expect to close our work here on December 15 and return to San Juan, taking with us data and material to be worked over there. PREVALENCE OF DISEASE.

No health department, State or local, can efectively prevent or control diease uithout knowledge of when, where, and tndr what condton cases are occurring.

IN CERTAIN STATES AND CITIES.

SMALLPOX. District of Columbi Report for November, 1913. The health officer of the District of Columbia reported that during the month of November, 1913, 1 case of smallpox had been notified in the District of Columbia. Idaho Reports for September and October, 1913.

Places. Case. Deaths. places. Cases. Deaths.

Idaho (Sept. 1-30): Idaho (Oct. 1-31): Counes- Counties-

Bannock...... 2...... Ada ...... 2 . Bonneville ...... 9 e...... v...e .1...... Cster ...... 1 Nes Perce ...... 6 ...... 6 Le.is ...... 3

Caffornia-Los Angeles. Senior Surg. Brooks, of the United States Public Health Service, reported by telegraph that during the week ended December 6, 1913, nine cases of smallpox were notified in Los Angeles, Cal. Massahuuetts-Vineyard Haven-Correction. On page 2537 of the Public Health Reports for November 28, 1913, appeared an item stating that during the period from Novem- ber 19 to 24, 1913, 10 cases of smallpox had occurred in Vineyard Haven, Mass. These cases were diphtheria-not smallpox. New York-Niaara Falls Acting Asst. Surg. Bingham, of the United States Public Health Service, reported that during the week ended December 6, 1913, three new cases of smallpox were notified at Niagara Falls, N. Y. No deaths occurred. (2691) December 12, 1918 2692 sMALLPOX-Continued. Texas-Eagle Pas Acting Asst. Surg. Hume, of the United States Public Health Service, reports thia oi November 18 tWo o of smallpox were placed in detention at the detention camp at Eagle Pass, Tex City Repwor for Week Ended Nov. 22, M13.

Pas. cass. Deaths. place. Case. Deaths.

Altoona, Pa...... 5 ...... , 4 i...... Biddeford, Me...... 4 ...... 3. .zsC...... 25 ...... Butte, Mont...... 1 ...... -rrau eo, ...... 0 m...... 2 ...... _~~~~~~~~~INafii l ...... 10 ...... i ChticagofliIDd...... 6 ...... m or,as...... I ...... 1 ...... N. y ...... ' ?A ...... =ansyMC 5ans...... Kan ...... - 3 ...... I ...... 5 ...... 21 LA C W ...... 2 ...... Tolo,Xdal ...... 11...... 2 ...... Le gt Ky...... 2 ...... ToeoOhio 2. . TYPHOID FEVER. Idaho Report for September, 1913

Number Number of new of new camot cases Places. Plaes. reported during sIWth. month. I ,, t Idaho: Idah-continued. Ada County- Idaho County...... 2 Boise...... 7 Cunty...... 5 BaRnock County...... 4 Nes Pre Ct ...... 14 PoeteUo...... 1 5hosh County- BanynoilBomievlbCountyCoty...... -5 ...... am ...... 10 Total...... 52 Goodna Kty...... 3 Idabo Report for Ottober, 1913

Number of new

- cases cas;e Places. Plaes. reported month-- durinig month. - 1 n a- Idah: ud. Ada County- idsh,= County...... Bd6ft...... 10 Idaho Cou ty ...... -...... Bannock County ...... 3 23 Pocatelo ...... 2 j oA ...... gham Coty...... 6 I 2693 December 12, 1913 TXPflMD F.iVR-uC4Wtiauqd. * -rfor Week Ended N.. 22, 1913.

Plc. Cae. Deaths. Cases.cam. reaths.

Atlantic CMy N. I...... 1 MolXinI...... i. Austin, Tx...... a orritown N. J...... i. Nashve T ...... 4 Baltimor, Id...... 17 ...... Binghamton, N. Y...... 1 Newark ...... 3 ...... Boston, Mass...... 6 New Bord, ...... 2 Braddock, Pa...... 1 ...... Newburrt as...... 2 ...... Bridgept Con...... 1 3.... . New Cae, a...... 1 Brockt=li;lha...... 1 ...... Now Orle, La ...... 9 Brookll ...... 1 Ni aFalls N. Y...... 1 Buffa . Y...... 9 .NdnL ...... Cambridge Man...... 1 iL...... 3 Camden, N. J...... 1 1.... . Pawtucket R ...... 1 Chicago, ...... 68 ...... Phlpha Pa...... 32 3 Cinctinati, . 4 3 ...... -- ias...... Ceveland, Ohio...... 8 ...... PitW, 2 ...... 1 Coffe A1ll, K n...... 1 Providence, R. I...... 4 CumrlaDd Md ...... RRWcmE, PaV...... 4 .31 Dayton, O ...... 2 ...... 2 ...... Erie, Pa.. . .. 1 Roeadne,g a...... Evansvlle ly.....d 86 Sagin,aw, 3lch...... 1 Everett, 4 ...... 1 1 8,Bt.Jomnh Mo...... 2 Fall River, Mass...... 2 ...... 31 1 Fitchburg, Mass...... 1.... . I'BanFis...... S Grand Rgs,-' Mich ...... ',SouthBedindI ...... Hartford Bon...... South Beth.ehem,Pa...... 1 1 M Haverhl, Mam...... 2 i prlngfild,Mas...... 2 Lancaster Pa ...... 21 ipdDlbd, 9 Los Anges Ca ...... 9 Tlrenton,.n . J ...... 1 Lowel'mLowel -as ...... 2 W Mass...... 2 L 2 W sh , D 9 nnc tr N. H...... 2 Wilmington, N...... 1 Milwauke, W ...... 1 YokPta ...... C...... 3

CEREDBROSINAL MENINGIElS. Idaho Report for Oetober, 1913. The State Board of Health of Idaho reports that during the month of October, 1913, one case of oerebrospinal meningitis was reported from Boise, Ada County. City Reports for Week Ended Nov. 22, 1913.

P2~ce. .I Cases. Deaths. Places. Cases. Deaths. 1- IIIl Bridgeport, 1 Lynn).u...... 1 Chicago, Iml Counn...... I...... I . 1 M71wilwee, Wis...... 1I Cleveland ...... 2 . Ohio...... 1 I .. New Bedford, Mass...... Danville,DnLos eti . .l ...... 1... . NOW orl, LA...... 2. FrankHli, N. B ...... I I St. Mo...... I. .. .. Los Louis, x\ng-obsw ...... I Wimington,-N. C...... I! POLIOMYELITMS (INFANTILE PARALYSIS). Jdi Repat for &epbmber end October, 1913. The StWe Board of Health of Idaho reports that during the month of September, 1913, one case of poliomyelitis was reported from Po- catello, Bannock County, Lnd duiiag October one case was reported from Boise, Ada County. December 12,1918 2694 POLIOMYELITIS (INFANTILE PARALYSIS)-Continued. aityC Reprtsfor Wek Ended Nov. 22, 193. Plae. Deaths. Placb.

. ... Joston ...... s 1i LOS ...... 2 1 ambd mm...... 1 ..H .....; ...... 2 CbhlcagoE...... Ph Ps ...: .... :.::. . I...I.... I Cloed, Oh io...... 2 St. 2 ...... F Fitchbur, m ...... 1 ......

ERYSIPELAS. City Reports for Week Ended Nov. 22, 1913.

Placs. Deaths. Place. Deaths. ll l Bayonne, N. J...... New Castle, Pa ...... I 1 Binghamton N. Y...... i.... Norrstown Pa ...... Bu lo, N ...... 2 Philadelphia Pa ...... 12 2 Chigo m...... 14 ...... Pittsburgh, P~a ...... 12 l Cincinnati, Ohio...... 1 1 Providence, R. I...... Cleveland, Ohio...... 3 Readg, Pa ...... Coffeyvile, Kn...... 1 ...... 1 8t.J h ...... 1 Erie, Pa...... 1 St...... I 10 A ilel Cal. 1 an cal ...... 3

2 Wil ......

PELLAGRA. During the week ended November 22, 1913, pellagra was notifiedl by cities as follows: Chicago, Ill., 1 death; Hartford, Conn., 1 case with I death; Nashville, Tenn., 1 case; New Orleans, La., 1 death. PLAGUE Rats Collected and Examined.

Week Found Total Found Place. ended- dead. colleced. -Examined. infected.

!- ~ ~ ~ ~ ~ ~ Cahornia: Cities- Oakland...... Nov. 15,1913 16 2 "A4I 572 . Berkey...... doD. 166 127 . San Frncisoo...... do 8 2,033 1,433 . Caflfornia-Squirels Collected and Exned. During the week ended November 15, 1913, 3 squirrels from Ala- meda County and 2 from San Benito County were examined for plague infection. None was found plague infected. PNEUMONIA. City Reports for Week Ended Nov. 22,,1913.

Plae. am. Deaths. Plae. Cases. Death>.

I I 11 _ ..I - Binghamton, N. Y...... 10 4 New Casl, Pa...... 1 Chlego, m. '...... 131 83 Nca m Pa...... 1 Cleveland Ohio...... 23 14 Phlladeiph(a, Pa.::...... 27 Dunkirk, W. Y...... 1 1 Pittsburgh, Pa...... 43 :3 Erie, Pa ...... 2 ...... Reading, Pa...... 2 ...... Grand Rapids Mich...... 4 o, Cal...... 9 LosADgs,U...... ' 16 5 Steelton, Pa...... I Mlount Vernion, N. Y...... 2 ...... York, Pa...... 2 695 Decmber 12,1913 RBAD During the week ended November 22, 1913, a death from rabies was notified in New Orleans, La. Callfrnia-Berkeley and Oaklnd-Babies in Animals. Surg. Long, of the Public Health Service, reported by telegraph that during the week ended December 6, 1913, 2 cases of rabies in dogs had been reported in Berkeley and 2 in Oakland, Cal. TETANUS. During the week ended November 22, 1913, tetanus was notified by cities as follows: Chicago, Ill., 1 case; New Bedford, Mass., 1 case; New Orleans, La., 1 death; Pittsburgh, Pa., 1 death; St. Louis, Mo., 1 case with 1 death. SCARLET FEVER, MEASLES, DIPHTHERIA, AND TUBERCULOSIS. Idaho Report for September, 1913. The State Board of Health of Idaho reports that during the month of September, 1913, 1 case of scarlet fever and 5 cases of measles were reported in the State of Idaho. Louisille, Ky.-Scarlet Fever and Diphtheria. Surg. McIntosh, of the Public Health Service, reported that during the month of November, 1913, 22 cases of scarlet fever and .51 cases of diphtheria had been notified in Louisville, Ky. City Reports for Week Ended Nov. 22, 1913.

Dih- Scalet Tubercu- OhUvb0 Total ther, Mesles. fever. l losis. tion, deaths 560, _...5 2 .. 6 . 1 Cities. 3ta from2 cuses.~

Over 500 Inabitants:000 Baliore~~~~~~~~~~St.aLousN d...... 5. 8,485 180 41 2 7 1919..17 Ai 8' 4 6 21 02

Cbicago, I ...... 332,185,283 682 204 16 22 3 130 5 69218 cleweai Oi ...... 560,663.. 97.97 5 23 ...... 16 3 18 19 PhiladelpAla Pa ...... 1,..549,008 486 64 14 24 ...... 70 6 40 75 itbugh,i'a..533905 197 68 10 58 ....73 4 21 8 St. Louls,CWalMo...... 687,029670 243202 6627 6 4 ....2422 ....17...... 42 ....4018 55 24 FromLo 300,000pAngee to 500,000 inhabit- 11 ants: Buffalo,N. Y..... 423,715 126 16 2 13 2 19 3 27 12 Cinriati, 107 36 2 ... 15 ...... 29 11 Pittsbhr ,Ohio..364,4635...... C - 3'0M201111... f.. 0 9 1 LosAneRI ...a 319,198 23 2 6 4 ...... 13is Mllwaue'eWs ...... 373,857 86 36 3 7 1 13 2 12 5 Newark R,I ...... : 347,469 102 58 2 53 ....16 ....3 11 NewOrl;~i IA ...... 339,075 133 59 3 5 .... 5 .... 20 17 San Francisc Cal ...... 416,912 118 9 1 2 .... 3 .... 26 13 Washlngtcni.C.... 331,069 120 16 ....S... 10 ....19 15 JerseyCity,N.3...... 267,779 66 ....2...... 6 Providenc, R. I..3.....24,326 66 24 1 15 2 4...... 6 December 12, 1913 2696 SCARLET FEVER, MEASLES, DIPITRIA, AND TUBERCULO ontd City Reports for Week Eaded Nov. A2, 1913-Continued.

Diph. Mesles Scarlet Tgbercu- Total tbi. eva>. 1lo^. t ^m . Cities. states from we- 1910;

From 100,000 to 200,00O hsabit- ants: Bridgoort, Conn...... 102,64 104,839 . 30. 6 92 1 3 5 2 camtont,T aii.S...! ...... 116 577 58 32 1 16 ' 2 1 6 F^lRiver, Mass...... 1129, 01 1 ~~9.... 7 5 O RuiRids, Mich...... 112,571 19 3 ...... 318 I ...... 78 1 11 109294 27 7 1 7...... 7 3 NsshvI 1e,sLm...... 110364 6 1 ...... 2 5 5 RlcE n4 Va...... 127,68 40 ~ 2 15 ..... 10 2 56 5 ..... 21. 10 1 5 168,497 1 Woresiter, M ...... 145,96 40 8 1 9 .... 2 6 7 From 50,000 to 100,000 Inhabit. ants. Altoona, Pa...... 5:2,127 130 2 1 ...... 1 Bayonne, N...... 16 9 ....'7i' 3 1 4 . 3 2 Broedfor Mass.... 58,878 8 12 .. 7 4 Pawdcn t J...... Pa...... 7...... I ...... 3 4 ...... REe, . ...3... 2 bahisvaie Ihd...... 27 12 '' '1 ....''i32'i 2.2 PeP...... 22 15 1. 98,915 26 9 10 ..... T~EIton, N.J...... 70,894 ...... 914 2 Wikes-Barre,Pa...... 55,482 ''''822 ''''i'...15 1 7 ...... 2...... 7 3 Aant Cit, ...... 82,331 ...... tln, Tex...... 2....7.. 89,336 '''''2 ...... I...... 2 ''' EtmOancegr N. H...... 70,063 '''2'''219 5.7 ...... 2 NewBedfor dMa ...... 27 ...... 6 3 Pawtucket, i. I...... Readier, Pa...... 96,071 22 12 1 . 12 3... 1 ...... ~ Michw ...... AO w 8tophMO ...... 77,403 6 20 12 ...... 7 ...... 4 SothB; Ind...... 5 22.. I ..... Sprield, iU...... 51 678 MKass...... pringteld, ...... Iomton, N. J .. 9,815 488 .....3...... I ...... 5, , 6 7 8 WilkeBarrePa ...... 67,105 20 6 1 2...... Yonkers,N. i Y. 25 17 ..1 0 1...... 2 2 From 25000 to5,

...... itants: ...... 1 ..... '' 2 ...... Atlantic City, N. J ... 46,150 6 ....,2118...... 1...... 3 - ..... 29 807 a,11...... 1 . Atngex...... 29,8gB ''''''?14 13 ...... lo ...... 3...... I ...... 2 Bht N N.Y...... 48,443 23 ...... P$olsflbel,Mass ...... 1...... 2...... ' Butte,mlont ...... 23 2 ...... Chla1...... 822 14 1 3 . 3 .. ..1. 1 ...... 3 ...... 25,401 5 1 ...... I Reoke,a...... 27,87 12 2 1...... 2 ...... Sth O a N r...... 84,371 83 ...... ,.... 1 18... .. 3 ...... '...... Superior, Wh...... 87,176 Tawuett, Ma...... 83,484 FWlt m, Mass...... 826 58 1 ...... 2...... 3....2...... 2 .. 1...'''' hg, Ma~...... 44115 iLv, Tenn...... 86s'346 |. i8 2 1..2 2 23 s+e, Wig ...... 80:417 La0 Pa...... 47,227 3 ....I...... Lexitn, lR ...... S3J099 1 2 1...... 12...... 2. .2...... 3' Lync h br,V...... 20494 13 I 906''i...... 2 ...... 2 ...... Munt no,NY... 30,919 9 32 1...... -@@ ...... 1, ...... '' 1 X Pa....s...... potk ...... $0 309 r4 0,...... 8068, .. 2 lrVaEN. Y...... 80445 1, 4 .. 1... Nagtowvn, Pa...... 27 875 .6.2 .2" ...... ; .... N .J...... I ... 206301 Pel a...... 32,121 22. PoRmouth V...... 83,190 Rahe is...... 88,00 :9 ...... RoanoW Va ...... 84,274 2.... h O,Nebr...... 26,259 i1 2 ...... 1 1 8,i...... 40,384 ...... 84,259 l, a . Waltham,q Mass...... 27,834 12 2 ...... 1... 1... 2697 December 12, 1913 SCARI FEVER, MEASLES, DIPHHERIUA, AND TUBERCULOSI-Contd. City Reports for Week Ended Nov. 22, 1913-Continued.

Diph- Scarlet Tuberc- Pppular Total theia. Measles. fe,ver. logS tion, deaths Cities. Unit from - § states all c19101910. causes. t 3. Iz I --I- I - From 25,000 to 50,000 inhabitants-Cotinued. 5. West Hoboken N. J...... 35,403 ...... 6 wUmlgtng Rt. C...... 25,748 15 .53...... I York, Pa...... 44,7.50 ...... 4...... I Z Ohio...... 28 025 ...... Lesn 25,0k) inhabitant: 25...... ,C...... 23,383 24.... nArbor Yich...... 14,817 10 .6 Beav F P ...... 12,191 0 ...... Biddeford, e...... 17,079 ...... - Braddock, Pa...... 1,357 ...... 1 Cambrld, Ohio...... 1,327 4 ,...... 13,075 3 Clinton a...... Coilhyvlle, KRas...... 12,687 ...... i.. Columbus Ind...... 8,813 1 1... , .. 1 Concord H...... 21,497 10 ...... CuXmbesind, Md...... 21,839 8 ...... I 1... DUnklrk, N Y...... 17,221 4 1.1 ...... Franklin, N. H...... 6,132 4 ...... 1.... .I 1... Galsburg, MI...... 22,039 4 1 1... Glouoest Mass...... 24,398 7 1... Harrison T I...... 14,498 3 -1 ...... 3.i ...... Kearny, J...... 18,659 7 ...... La Fayette d. 20,081 5 ------1 14,610 2 1 ...... 1...... sO i...... 13,879 5 -. ---...-- Moilnemt,is...... 23,150 10 ------.-.--1 ...... Mon N...... 15,715 5 ...... 24,199 1 1 ...... 8 2...... '''-9- --'-'-I1.... -I ...... 21,550 NanticokeMeorron tN...... 12,507 4 '...... ' 121 Nanticokcs, MPaw...... 18,877 4 2...... I Newburyport, Ms...... 14,949 2 ...... North Adam*, MXass...... 22,019 5 3 NorthamooN. Mass...... 19,431 10 2...... 8,610 3 ...... 1 PotPiln1iXd,N.7J...... 20,550 4 Pot P ...... 15599 3 1 Rutland, Vt...... 3,546 5 South Bethlehem, Pa...... ,973 5 Steelton, Pa...... 4,248 ...... 8. 2 I...... Wilklnsburg Pa...... 18 924 .i...... Woburn, h ...... 15,308 8 .....I 191 IN INSULAR POSSESSIONS.

HAWAII. Plague-Infeeted Rat-Honokaa. On November 4, 1913, a plague-infected rat was found in the vicinity of the new stable camp of the Honokaa sugar company. Eamination of Rats and Mongoose. Rats and mongoose have been examined in Hawaii as follows: Honolulu, week ended November 15, 1913, 441; Hilo, week ended October 25, 1913, 12,180; week ended November 8, 1913, 3,824. P PPINE ISLANDS. Cholea-Mbania. During the week ended November 1, 1913, 16 cases of cholera with 16 deaths were notified in Manila. (2698) FOREIGN REPORTS.

AUSTRIA-HUNGARY. Status of Cholera.

Cholera has been notified in Austria-Hungary as follows: Bosnia- Herzegovina, October 12 to 21, 1913, 16 cases; October 24 to Novem- ber 5, 1913, 8 cases with 2 deaths; Croatia-Slavonia, October 6 to November 3, 1913, 147 cases with 63 deaths; Hungary, October 26 to November 1, 1913, 32 cases with 25 deaths. BULGARIA. Declared Free from Cholera,

On November 4, 1913, the kingdom of Bulgaria was declared free from cholera. CHINA. Cholera-Plage-Hongkong, During the week ended October 18, 1913, 9 cases of cholera and 4 cases of plague with 4 deaths were notified in Hongkong. During the same period 2,421 rats were examined in Hongkong for plague infection. None was found plague infected. CUBA. Communicable Diseases-Habana. Nov. 10-20, 1913.

Remaining Diseas. New cases. Deaths. under treatment.

LOy ...... 1 1 259 Ma- Ii...... aI ...... I19 Typhoid ever.4 2 38 1 Dipht .. . i 5 Scarlet fever ...... 4-...... - 5 Measles ...... ,,,...... 34 56 Varicella.t...... fever 1...S5 Paratyphold .1...... 1....

'All from interior points of the Republie. (2699) December 12, 1918 2700 JAPAN. Communeable Diseases. Cases of communicable diseases have been notified in the Empire as follows: MONTH OF AUGUST, 1913.

Dheaes. Cas. Deaths. Dieae. Cases. Deaths.

Chola ...... 2 .. cSrlet fever...... 54 Diphtheria...... 799 168 Smallpox...... 14 8 Dysentery ...... 4,268 875 Typhoid fever...... 3,900 647 Paratyphoid fever ...... 8284 a 'Tokyo, 7 cass wtfh 4 deaths; Kanagawa-ken, 1 case. Summary of Communicable Disease. JAN. 1-AUG. 31, 1913.

Disa. Cases. Deaths. Diseases. Cases. Deaths.

Cholera ...... 78 22 Scarlet fever...... 91041 Diphtheria ...... ; ... 12,714 3,356 Smallpox...... 3395 Dysentery ...... 9.,257 1,873 Typhoid fever ...... 13,884 2,612 Paratyphoid fever ...... 1,916240 MEXCO. Yellow Fever-Merida. On November 16, 1913, a death from yellow fever occurred at Merida in the person of a soldier who arrived November 15 froi Campeche. ROUMANIA. Status of Cholera. During the period from November 6 to 12, 1913, 11 cases of cholera with 7 deaths were notified in Roumania, making a total from t1e outbreak of the epidemic to date of 5,677 cases with 2,925 deaths. On November 12 there remained under treatment 13 cases of cholera. RUSSIA. Status of Cholera. During the period from October 19 to 25, 1913, 6 cases of cholera with 1 death were notified in Russia. The case.s were distributed in the governments of Kherson and Taurida. In the Kherson government from October 26 to November 1, 1913, 6 new cases and 9 deaths occurring in Kherson city and district were notified. SERVIA. Status of Cholera. Cholera has been notified in Servia as follows: October 18 to 211, 1913, 54 cases with 24 deaths; October 26 to November 9, 1913, 30 cases with 8 deaths. 2701 December 12, 1913 TURKEY IN EUROPE.

Cholera was reported present in Constantinople December 6, 1913. ZANZIBAR. Examination of Rats-Zanzibar. During the two weeks ended September 30, 1913, 2,494 rats were examined at Zanzibar for plague infection. Of this number, none was found plague infected. CHOLERA, YELLOW FEVER, PLAGUE, AND SMALLPOX. Reports Received Durng Week Ended Dec. 12, 1913. CHOLERA.

Place Date. Cases. Deaths. Remarks.

Austria-Hunr:Bosnia-He'regovina Bjela ...... Oct. 20-21 ...... 4...... 4 Brad ...... Oct.19 ...... 1...1 Gradiska ...... Oct.28 ...... 2 Poloj ...... Oct. 20 ...... 1....1 Bulgaria ...... Nov. 4, free from cholera. China:

Hongkong... Oct. 11-18 ...... Dutch East Indies: Java- Batavia ...... Oct. 18-25 ...... 11 5 Sumatra- India: Djambl,Province ...... do ...... 4 3 Bombay ...... Oct. 26-Nov. 1.... 3 3 Philippie Isans mlanla ...... Oct. 25-Nov. 1... 16 16 Roumana ...... Total, Nov.6-12: Cases,11; deaths, 7. Russia: Governments- Khesn- Kherson, district... Oct. 19-25 ...... 2..2 Kherson ...... Oct. 6-19 ...... 2....2 Taurida- Servia: Dnelper, district ... Oct. 19-25 ...... 2 1 Districts- Begrade ...... Oct.18-25 ...... 2 3

Kr ...... a...... Oct. 18-Nov. 2.. 8 5 Kroushevatz ...... Oct. 18-25 ...... 3.....3

Morava ...... do. 4 Niche... Oct.18-Nov.2 2

Pirot ...... do...... 6 2 Podrne...... Oct. I8-Nov...... 9 13 7

Pojarevats ...... do ...... 31 8 Roudnik. .... Oct. 18-25 ...... 1 1

-Tohatcak ...... Oct. 26-Nov. 2.... 1.

Waljevo. .... Oct. 18-Nov. 2.... 10 Wragne .... Oct.18-25 ...f 1 YELLOW FEVER. Mexico: Merida ..... Nov.16 ..... -.. 1 From Campeche.

PLAGUE. Brazil: Bahia Nov. 1-8 3 1 China: ...... Hongkong .Oct. 11-18 4 4 Japan: ...... Kobe . Nov. 2-9 ...... 1 December 12, 1913 2702 CHOLERA, YELLOW FEVER, PLAGUE, AND SMALlPOX-Continued. Reports Received During Week Ended Dec. 12, 1913-Continued. SMALLPOX.

Places. Date. Case. | Deaths Remarks.

Brasil: Bahia...... Nov. 1-8...... 2 Canada: Provine- Qubec- Montreal...... Nov. 18-22...... 21...... Dutch East Indies: Java- Batavia...... 1-...... 6 3 France: Pars...... Oct. -Nov. 1.... 1 ...... Mexico: 4:n s ...... Nov. 16-23...... 1...... O naca...... Nov. 2-17...... I...... 2 1 Nov. 8-15...... 3 Russla St. Petesburg...... Nov. 1-8...... 2 2 Swtland: Canton- Basd...... do . 5 ...... Turkey In Asia: Beiut...... Nov. 8-15 8 'I Reports Received from June 28 to Dec. 5, 1913. CHOLERA.

Places. Date. Case. Deaths. Remarks.

Arabia: Hodsidah ...... Aug. 27-Sept. 4.... 3 2 Do...... Aug. 20-Sept. 4.... 123 21 Among the military at quarani- tine. Austria-H gary: BosnaHerzegovin- Bijela...... Aug. 16-Oct. 13.... 7 ...... Bolanic...... sept. 30-Oct. 13... . 2 Boiacsch Samac...... Aug. 16, Set. 15.. 7 Brad...... Sept. 30-Oct. 7.t.. 1 ...... Breko...... Aug. 1-Oct. 31.... 50 Breovopole...... Sept. 1-30...... 1 Bu ne...... Aug. 1...... Creveo Brodo..... Aug. 28-Sept. 6.... Dereventa...... Oct. 1631...... -aDonja ..kva Aufg. 1-27. 1 ...... Golovac...... Sept. 1-30...... 1 GorndJa Tu..a...... Aug. 1 pt. 7..... 6 ...... Gracam...... Aug. 16-27...... 1 ...... aca ca...... Set.30-Oct. 31.... 6 2 Gradta...... Oct. 16-31...... 2 ...... 2 Janja...... Aug. 28-ept. 29... 5 Kostain. a...... Spt. 30-Oct. 13... 2 Labuca...... do. 1 ...... Lajubaca...... Aug. 28-Sept. 6.... 1 Morac...... do. 2 ...... Orasie...... Aug. 16-Sept. 29... 18 Tuuia...... Aug. 28-Sept. 29... 2 UlJUce...... Aug. 16-26...... 1 ...... Vidovice...... Aug. 16,Sept. 29... 9 ...... Vusic Doinji...... Aug. 164Sept. 7.... 3 Vuic Gori...... Aug. 16-Sept. 15... 4 1 62; Croatialavona...... Total Oct. 6-12: Cases, deaths, 22...... 7..... Pozeu ...... Brod...... Sept. 29-Oct. 5.... 4 1..... Davor...... do. 2 Jasenovac...... Sept. 22-Oct. 5.... 2 Novsksa...... Septt22-28. 1 Syrmien- Adasev...... Sept. 8-Oct. 5.. 12 Alt Slankamen.... Aug. 18.. 2 Ba...... Sept. 8-14..... 5 Bebrima...... St. 1-7...... 1 Badm...... Spt. 14-28...... 2 14 UB mtrove ..... do. 1 2703 Decmber 12, 1913 CHOLERA, YELLOW FEVER, PLAGUE, AND SMALLPOX-Continued.

Reports Reelved from June 28 to Dec 56, 1913-Oontinued. CHOLER-Coesnned.

Plac. Date. Cas. Deaths. Remarks. --l -C40ontinued. AustraC-Croas onia-Contd. Blc,Zupenja Aug. 16-Sept. 28.. 39 13 Boact...... out. Aug. 26-Set. 28.. 4 2 Cea...... Sept. 22-Oct. 5.... 9 ...... Cortanovei...... Aug. 2-Sept. 28... 6 Djakova...... Aug. 25-Sept. 2.... 1 ...... Druxovi...... Sept. 14-28 6 Galubinci...... Sept. 8-Oct. 5..... 18 6 Grad Mitrovima Sept. 1-14...... 2 1 dJ:rit. Grad, Zemum dis- Sept. 8-14...... 1 1 trict. Iltci...... Aug. 26-Oct. 5.... 2 ...... Klenac...... 8et. 29-0ct. 4.... 2 Kreevna...... July 31...... 5 3 Kupinovo...... Aug. 17-Spt.22 ... 2 1 Kutina...... Aug. 26-et. 2.... 1 ...... Kuzmin...... 142 ...... Aug. 26-Oct. 5.... 13 1 Martin ...... Aug. 16-Oct. 5.... 19 13 Mianovici...... Sept. 29-Oct. 6.... 2 ...... Mitrovi...... July 154-et. 28... 10 5 Morovic...... ftpt. 14-28...... 1 Novo Karlovol..... Aug. 26-Oct. 5.... 30 Novo S8lnkmen... Sept. 8-14...... 1 1 Ogar, Ruma district .....do. 2 1 Ogar, Sid district. . Sept. 8-Oct. 5..... 17 5 Osek...... Sept. 22-28...... 3 1 Otok...... Sept. 1-7...... 2 1 Podgajci...... Aug. 16-Sept. 14... 3 2 Raca...... Sept. 22-28...... 1 1 Rivica...... Sept. 8-14...... 2 2 Semlin...... Aug. 25-et . 22... 2 2 Sid...... Sept. 29-Oct. 5.... 1 ...... Siskovei...... Sept. 22-Oct. 6.... 4 2 Tovrnik...... Sept. 14-28...... 2 Vikovei...... Sept. 8-14...... 1 VoJka...... Sept. 14-22...... 1 Vucovar Argoviste. ....do.. 1 Zuinge...... 8ept. 22-25...... Present. Bohemia- MalenUbad..... Sept. 13...... Weinberge...... Sept. 27...... Dalmatia- Cattaro...... Aug.6...... 1 - 1 Gem Skole- Ov'zc...... SePt. 10-Oct. 6.... 15 9 S&^wco...... do. 1 ...... Tuchil...... Sept. 18-Oct. 6.... 2 2 Tucholka...... Sept. 10-Oct. 6.... 1... .i Wyzlow...... do. 1 Loer Austi- 1 Vinna...... Aug. 4 ...... et. 1-Nov. 5: Hun ry...... - ...... I- 1- ... " I Total 615; deaths, 102. Death ffOt hIU; reported. Bacm-Bodrog- Ada...... Sept. 7-13...... 2 Apatin...... t. 29-Oct. 4.... 3 Bacs...... Sept. 14-27..... 3 Cerog...... Sept. 2-Oct. 4..... 20 Kopy...... t. 14-Oct. 4.... 2 Po...... Sept. 7-20...... 2 Obese...... Sept. 7-Oct. 4...... ii. ept. 14-Oct. 4.... 2 Temerin...... do. Jbolvwezke...... Sept. 21-27...... 1 Boshalom...... do. 2 Coabhal ...... Oct. 4...... 1 Fedsveczke...... Sept. 7-27...... 7 Harflva...... do. 2 Kanora.------Sept. 14-20...... 4 Dasesuer 12,1913 2704 NWZRA, YLIOW FEVER, PLAGUE, AND SMAILPOX-Oontinued. geIwtH oIaved fom Jam 28 to Den6,5 191-. inued. CROMA-Contnud

P_ae. Date Cases. Deaths. Remrks

Abi r-Hua Continued.

Sept. 21-27...... 7 ...... Kssoly" ...... Sept. 7-13...... 2 ...... Yukm...... do. 1 ...... Nagyluck ...... Sept. 21-28...... 1 ...... Odavidhza...... Sept. 7-13. 3 ...... Orosztelek...... Sept. 7-28 -.... 4 ...... Prozu e...... ept. 14-20...... 3 ...... Rakoczssallas .... ept. 14-28...... 9 ...... Bzarvoskut...... Sept. 21-28...... 4 ...... Sszntom lklos.... . ept. 14-28...... 13 ...... Solyvay...... Sept. 21-28...... 6 ...... Tarpp...... Sept. 21-Oct. 4:... 4 ...... Ujdavidha ...... Sept, 14-28...... 5 ...... Varkulesa...... Sept. 7-Oct. 11.... 6 ...... Varpalaka...... Sept. 21-28...... 3 ...... Vezersallas...... 21do 11 ...... Volose ...... Sept. 7-Oct. 4.... 2 ...... &3jago...... Sept. 7-13...... z8aiup...... Sept. 21-Oct. 11... 1 ...... Zugo. Sept. 7-Oct. 11.... 6 ...... Borsod- Sajolad...... Sept. 28-Oct. 11... 22 ...... Budapest- Budapest...... Sept. 13-Oct. 4...... Fejer- Adony...... Oct. 4...... 1 ...... Pazmand...... Sept. 21-28...... 1 Heves- Ludas...... Oct. 5-11...... 1 ......

Poroszlo...... do. 1 ...... Jassz - Nagykun - Szol- nok- Tiszaroff...... Ido 2 ...... Kolozs-

Koloszvar, Klaus- Sept. 21-Oct. 11... 17 ...... enburg. Komarom,Komorn Sept. 29-Oct. 4.... 1 ......

Mezoszopor...... Oct. 4...... 2 ......

Panesova...... Sept. 29-Oct. 4.... 1 ...... Krasso.Soreny- Bozovics...... Sept. 14-Oct.1l.... 6 ...... Dalbosfalva...... Oct. 5-11...... 5 ...... Illyed...... Sept. 21-Oct. 4.... 7 ...... Jam...... do. 7 ...... Nagylaposnok..... Sept. 14-Oct. 4.... 23 ...... Nerameos...... Sept. 21-Oct. 11... 4 ......

Neramogyoros. Sept. 7-14...... 18 ...... Stanelalreia... Sept. 21-28...... 1 ...... 8r...... Sept. 14-Oct. 4......

Ensebetfalva...... Sept. 21-28...... 21.,211 ...... FaII...... Oct. 5-11...... 1 ...... H¶Lgkut...... Sept. 21-28...... 2 ...... Raczksve...... do. 2...... Do...... do......

-Tokol.* ...... do. 1 ...... -Pamo, Pressburg- Kisnua ------. Oct. 5-11...... I...... SBatmar- 31. Tkaabecs...... Oct. 4...... 8...... Tames- Deliblat...... Sept. 1-Oct. 4..... 31,...... Homokos...... Oct. 4...... Kevevera...... Aug.1e4ept.20... Palan...... Aug. 10-Oct. 4.... 16 Temesvalalza...... Oct. 5-11...... 7. Torontal- COenta...... Oct. 11...... 6. Melne...... Sept. 14-20...... 2. Sept. 21-28...... 1. Kuman,...... Sept. 14-28...... 8. p...... Sspt.14-Oct. 4... 6. ss...... Spt. 48...... 1. ULg- o c ...do...... 1. 2705 December 12, 1913

CHOLERA, YELOW FEVE PLAGUE AND MALl"POX-ontinued. Rpbdved from June38 to Diw. S, 1913-Continued. CHOLE3A-00tinned.

Plae. Date. Case. Deaths. Remarks.

Auutr-EH yontlnued.

Nart...... Sept. 21-28...... 3 P s Jvar ..... Oct. 5-11...... 1 Titel...... Sept. 17-27...... 1 nglovasad...... Oct. 5-11...... 2 Zala- Nayknlzsa . Oct.11...... 61...... Radvane ...... Sept. 14-20...... I ...... Zem len- "atoraljan= ly... Sept. 21-28...... -1 1 ...... Bulga .ia...... I ...... Sept. 10, present in the districts of Pleven, Sivistov, Vratza, and Widin. Rustlhuk...... Sept. 8...... 18 8 Sistovo...... d ...... 60 ...... i. Tirnovo...... do. 14 Varna...... l 11...... 3 ...... Aug. 25, 3 deaths among return- Sept. ing soldiers. Ceylon: Colombo...... Set. 30-Oct. 25.. 461 34 Aug. 17, 1 fatal case. China: Amoy...... Aug. 23...... Present in vicinity; Oct. 4, present. Canton...... July 13-26...... 132 6 Chuan Chow...... Sept. 6...... Present. Foochow...... Set. 13...... , .....ii* Do. onkong...... Aug. 3-Oct. 11.... .83~ Swato ...... Aug. 1-31...... 31 30 Dutch East Indies: Bomeo...... Total, May 12-June 7: Cases, 131; deaths, 105. Sesajap, district...... May 12-June 7.... 57 40 Java- Batavia and Tanjong- May 18-Oct. 18.... 578 470 May 25-Oct. 18: 14 cases and I Priok. death among Europeans. Madioen, Provinoe..... Apr. 22-28. 1 4 Pamanoekan...... To Oct. 4. 34 27 Pekalongan...... Aug. 10-Sept. 20.. 110 76 Preanger...... Aug. 9-1. 41 23 Samarang...... July 12-Aug. 16.. 18 11 Surabaya...... Aug. 2-23. 2 ...... Sibiru...... Mar. 24-Apr. 27... 117 Sumatra- Djambi, Province...... June 1-Oct. 11. 321 153 July 15-Aug. 17 not received. Padang...... Sept. 11-20. 5 4 bang...... June 22-Oct. 18.... 278 165 Greece:Greece: Athens...... Sept. 15-29. 1 1 Pru...... Sept. 13-Oct. 13... 9 5' Among troops at qurantine. India: B ...... May 4-July 19. 31 23 Sept. 27, 1 case. Bombay...... May 25-Oct. 25.... 52 .35 Calcutta...... Apr. 27-Oct. 18...... ii. 569 Madras. June 15-Oct. 18.... 10 Moulmine...... May 4-June 14.... 6 6 Negapatam. . Sept. 14-27...... 29 Rangoon.... May 1-Oct.11 5 IndoChina ...... Total, Jan. 1-Sept. 10: Cases, 213. -I Deaths, Jan. 1-July 10: 145. 17-23 2 Saigon ...... June ...... 21 ...... Total Jan. 31: Cases, 78; Japan ...... 1-Aug. deaths, 22. Aug. 1-31, 2 cases

Kobe Ipt. 5-8.. From s. s. Canada Man. Crew .. . 7 ...... quarantined at Wads. From s. Canada Na ...... Aug. 25-31 Maru. Islands ...... I...... Oct. 19-25 In Bacoor Philippine ...... present Cavite anrov1nce. d in Pa ranaque, San Filipe Nary, and Pasig, Rizal Province. m . 71 ..... 25 Ot 43 A:g 26 cae on Cavite ..... 1 ...... Sept. 28-Oct. 4; 1 fatal s. s. Cebu. Meaam...... Oct. 5-11. 1 ...... 1 Noriebes...... Oct. 15-18. 3 In Polo e...... Spt. 28-Oct. 4.... 1 ...... BuLsan. December 12, 1913 2706

CHOLERA, YELLOW FEVER, PLAGUE, AND SMAlLOX-Continued.

RePort Reeved from June 28 to Dec. 5, 191S-Oontinued. ouRA-Contned.

Placs. Date. Cases. Deaths. Remarks. .- Roumania ...... Aug. 1-Nov. 6: Total cases, 5668; deaths,2,917. Oct. 16-22: Sfases, 169; deaths, 140. Bucharest...... A ug.5-14...... Brala...... To Sept. 2...... 43 Among the military. Do...... Sept. 3-8...... 4 Civiians. Galats...... Aug. 22-Sept. 2.... 34 6 Kustenje...... Sept. 3-12...... 8 Silistria...... To Aug. 25...... 26 1 Stephanesti...... Aug. 1-14...... 18 To Aug. 24...... 56 ...... Including previous reports. Turnu-Magureie...... Aug. 5...... Case present. Vilsoara-eleorman ...... do. Russia: Governments- 3 Besarabia- 1 Akkerman...... Sept. 16-18...... 4 IShmafi...... Sept. 16-Oct. 11... 26 ...... Kshinef...... Sept. 22...... 3 ...... Rei...... Oct 5-18...... WolIkanechty...... Sept. 18-21...... 1 Ekaterinlsav- Ekaterinislav dis- Oct. 5-18...... 5 trict. Nicopol...... Sept. 22-Oct. 11... 6 Kherson- Elizabetbrade..... Sept. 28-Oct. 4.... 1 1 ... 18... 28 Total, Au. 24-Oct. Kherson, district Aug. 26-Oct. 49 18: Cases, ...... 148; deaths, 66; Including previous reports. Kherson...... do. .52 14 Odessa, district.... Sept. 7-Oct. 4..... 39 17 Odessa...... do. 7 5 Varvaroka...... Sept. 22...... Present. Kf- Zvenigorode...... Sept. 8...... 2 2 Minsk...... Sept. 122...... 1 1 Poltava...... Sept. 18-Oct. 4.... 25 5 Taurida- Alechki...... Sept. 8-Oct. 4..... ,r 1 Dneiper district.... Sept. 21-Oct. 18... 3 2 Dneprovski...... Sept. 8-14...... 8 2 swr.a...... Total, July 4-Oct. 18: Cases, 4,710; deaths, 1,896. Districts- Belgrade...... July 4-Sept. 27.... 100 Sept. 22, 1 ca. Belgrade...... July 4-Aug. 30.... 262 250 Kraa...... Aug. 3-ept. 27. .. 257 95 KraguJevatz. July 27.... 281 94 4-Sept. 27 Kroushevatz...... do. 2365 2 Lalkovac ...... ---. Aug. 1-7...... 1 Morava...... July 4-Sept. 27.... 584

Niche ...... do. 327 14 Ou3 tz...... July 22-Sept. 27... 30 Pal. w...... Aug. 1-7...... 1 Pirot...... July 4-Sept. 27.... 625 237 Pod ...... do. 106 PoJarevatz...... Aug. 34-ept. 27... Po g...... July 25-31...... 1 Roudnikc...... Aug. 3-Sept. 27... 34 48 Shabatz...... Aug. 1-7...... 1 Smederevo...... July 4-Sept. 27.... 200 Tchatchak ...... July 22-Aug. 30... 45 7 Timok...... July 19-Sept. 27... 251 129 Toplitxa...... July 22-Sept. 27... 45 20 Uekub...... July 19-Aug. 2.... 37 19 Vlsnicasand Mievo.... July -21...... 377. 1 Waijevo .... July 2 pt. 27... 194

...... do 377 194 Siam:Sa:Wrage...... Bankok...... Mar. 23-Oct. 4...... 20 8trats Settlements: Sapore...... July 6-Oct. 18. 33 32 Turkey hi Asia: Derinde...... Oct. 11...... Prent among troos. 8mym ...... July 20-Oct. 12.... Aug. 9, 1 cas on a.s. Cwrsbad. Trebizond...... Oct 29...... Present among troops. 2707 December 12, 1913 CHOLERA YELLW FEVER, PLAGUE, AND SMALLPOX-Continued.

Rep_ Received fom Jue 28 to Dec. 5, 1913-Continued. CHOLR=-Contiaued. _~~~~~~~~~~~~~~~~~~~~~~ _ pl Date. Cass. Deaths. Remarks.

Turkey in ROpe: ....t..t.n.pl. Aug. 2..Nov. 2... 53 27

...... Oct. 28 present. ~~..t...... 17-Oct...... 2...8...... li8p.17c.Sept...... n...... i .. di Ocit. 12.. 2 ...... i. isof Marmora. Sept. 30, sll present. Ubodsh...... {Set 17-Oct. 5.... 12 8 1IM1A_ )--...... July A kL .. Jl 7-Oct 12... 511 19bH 1 Kavtla Drama, Kna Sw r,and oumit. 8i .Oct. 15-27 ... 4 4

YELLOW FEVER.

Brzi: Bahia...... May l1-Nov. 1.... 48 24 ...... June 30-July 5.... 6 6 Pernambuco...... May 1-June 30.... 3 Rio de Janeiro...... May 25-Oct. 18.... ''''''i' 5 Sept. 13-1 fatal case on s. s. Ca- nova from Bahia. Oct. 30, 1 death. British East Africa: iumu...... Sept. 12Oct. 13... 2 2 - 2 Mombasa...... do. 25 24 S5e pS s-I Nairobi...... do. 1 1 Colombia: Cartag a...... Aug. 23...... 1 Contracted in the interior. Cuba:

Haban...... July 16 ...... 1 case on a. a. Hydra, which left Manaos June 17, Para June 21. Four deaths occurred in voy- age; 2 at Manaos, 1 at Guanta- namo, and 1 at Cienfuegos. Do I Aug. 8-14 1 From steamship Moffo Castle, passenger from Campeche. Ecuador: Babahoyo...... June 1-July 31.... 2 2 Bucay...... June 1-Aug. 31.... 3 2 Dun...... May 1-31...... 1 ...... Guayaqull...... May 1Sept. 30.... 33 21* Nov. 6, increasing. M agro...... May 1-Aug. 31.... 21 11 Naranito...... do. 12 9 M ico...... Total May 25-Sept. 20: Cases, 27; deaths, 15. Campeche...... Oct. 18...... 11 Carn...... Oct. 11...... Present. Maxcan...... Aug. 23-Sept. 6.... 2 Case, Aug. 23, from Campeche. Puerto Mexico, V. C. Nov. 17...... 2 ...... Southem Nigeria: Fordo ...... Oct. 31...... L ...... May 12...... 1 July 23-Aug. 22: Epidemic; Oct. 15, stfll present.

Worni ..... June 1-30 1 Present. T ...... Nov. 28, 1 case on s. s. Peter Hamre. Venezula: Cm...... Feb. 1-28. 1 Do ... May 1-31...... From Valencia. Do...... July 1-31...... 1 Do...... Oct. 1-31...... 1 Do.

PLAGUE. Arabia: Aden...... June 3-25...... 8 4 Total Apr. 9-June 25: Cases, 81; deaths, 59. Debai ...... | ...... Aug. 31, free; repored, p. 656, Pt. I. Argentina ...... I...... Nov. 6, outbreak, with 25 deaths ln 41octtleswest from Rosario. Austrlung"y: Trieb ...... I Nov. -S...... 1 fatalcas on a post steamer from Buenos Aires. I From the VeOentlichunen des Xasenlihen Gesundheltsamtes, Nov. 12,1913. Deember 12, 1918 2708

CHOLER YEILOW FEVE PLAGUE, AND BMALLPOX-4ontinued. IR et- Reevedl fom Jun 28 to Dee. 51918-Continued. PLAGuZ-Couatnud. POlaces Date. Case. Deaths. Remaks

Brazil: Bahia...... May 11-Oct. 18.... 131 607 Rio de Janeiro...... July 27-Oct. 11.... 2 I British East Africa...... ay 15-June 12...... I I death. Kisumu...... May 15-Sept. 1.... i. Mombasa...... May 1-Sept. 11.... 89 Apr. 2-30, 15 deaths. Nairobi...... May 15-pt. 11... 9 Cephalonla.Ialaad...... Oct.4...... Present. Chile: Iquique...... May 11-Oct. 4..... Chia...... 5.J ...... I...... May 184-m 14; At Pent in Ampo, (2foyand, Fung hun Kityang Puning, Ta-bu and other poits along the rway. Amoy.. Apr. 1-Aug.25...... 409 May 25-une 7, 10 to 20 deaths daily; Sept. 22, free. Kulangsu ...... Jan. 1-May 24..... 29 June 7, 1 or 2 deaths daily. Cantnt...... Apr. 1-June 30: Cases, 229. Apr. 10-May 22,300 fatal cases in the Sunninger district. Hongkong. May 18-Oct 25.... 292 246 Kaochow. A ' 10-May 22...... 10 deaths daily. Macao. Jl3...... i...... Present Aug. 7,1913. Nangkin.. Oct. 25...... Present. Shangha.. June 1-15...... 8 Among natives. Swatow. July 12...... Decreasing along the Swatow Chaochowfu Railway. Dutch East Indies: Java- Districts- Kediri. Apr. 1-Sept. 30.... 1,6w 1,392 Madioen...... do. 598 538 Malang...... do. 3,507 3,358 8urabaya...... do. 166 157 Madura- Bangkalan...... July 13-Aug. 9.... 34 27 And district, Nov. 6, 112 cases. Ecuador: Guayaqul...... May 1-Sept. 30.... 94 28 Mao...... May 1-July 31..... 1 1 Egypt...... ;:..... Total, Jan. 1-Oct. 30: Case, 639; deaths, 299. Alexandria...... May 28-Oct. 28.... 32 15 Port Said...... June 2-Sept. 9..... 19 Provinces- Behera . ...:June 13-Oct. 2..... 11 Fayoum...... May 30-Oct. 11.... 46 1714 Galioubeh...... May 21-ept. 12... 7 2 Garbieh...... May 27-Oct 28.... 63 22 Jan. 1-May26: Cas,12; deaths, 5. Girgeh...... Oct1...... -1 1 Gizeh...... May 29July 1. 1 Menouf...... May 28-Aug2. 7... 363 3 Jan. 1-May 26: Case, 51; deaths. 24. Mbleh ...... May 30-Sept. 7.... 29 10 GermarEast Aftica: Districts- UsmawQ-

M...... Mar. 15-May 10...... Present. Nora...... do...... Do. Urima...... do. Do. Muanza...... Mar. 15-June 11... 503 459 Aug. 24, fatal ca from a.SybilI Greece: Athen...... Aug. 29.... 1 Pirseus...... Aug. 21-Sept. 3.... 8 IndIa Bombay...... May 18-Oct. 12.... 711 604

Calcutta...... A r. 27-Sept. 27...... 302 Karach...... Vay 18-Nov. 1.... 171 Rangoon...... May 1-Oct. 25..... 401 379 Provnces...... ;...... Total, May 4-Oct. 18: Cases, 40,013; deaths, 31,435. Delhi...... May 4-Aug. 2..... 24 18 Bombay...... May .4-c18..... 14,553 10,280 Mada...... 901 774 Ben...... May 4-Oct.18. 316 324 Bgiar and Orea...... do...... do. 1,927 1,539 United Provns...... do.Jue2 u. 3.....d 10,349 8,824 Punab...... do. 7,239 5,782 Burma...... 1,456 1 364 Coorg...... June 22-Aug. 30... 10 8 Centra Prov ...... Mar 4-Oct. 18..... 7 4 Mysr...... 2,8 1 1,570 2709 December 12, 1913

CHOLERA, YE W FEVEI, PLAGUE, AND SMALLPOX-Continued. etl from Jae 28 Doe. 5, 1913-Continued. LAGUE-Continued.

PaSM. Date. Cams Deaths Remarks.

IndIa-ContInued. Prolc3 o iiIn. Hyderabad .@v** May 4-OcL 18... 2 C4ntral India...... do. 31L .....icus...... do . I May 4-Aug. 2... 261 I North West Proice... May 4-Oct. 18.... 81 48 Indo...... I ...... S Total, Jan. 1-Set. 10's Case, 2,745; Jan. 1-July 10: Deaths, 2,547. Sigon...... Jun 17-Aug. 26.. ff. Japen: Taiwan- l ...... Jlune 1-July 19.... 81 61I Yokohama...... Sept. 19-Nov. 12.. 1 I Mauritlus...... Apr. 18-Sept. 18... 41I Total, Jan. 1-Aug. 28: Cases, 126; deaths, 70. Morooco: L Casablanca...... Oct. 2...... I...... Rabat...... Oct. 19-25...... 1.. I...... Persia...... I...... in June1505,cases at Caravadeh,hah Province,Haw rouabadKE nd Loud. June 11, prent vicinity of Abassa- DjameChouran...... May 31-Sept. 13... 37 21

Falabad...... June 11...... a Gommi...... do...... 11 IHar May 20-June25... 51 Laraaguenh...... d.d...... May 27-June 15... 30 28 Mahl-Dacht...... June 4...... 2 2 ...... Ta bat.. June 11...... 3 Zebyri...... May 31-June 25...... ii 10 Peru: Departments-

Chimbote...... July 28-Sept. 7.... 2 ...... Arequipa Mollmdo...... Apr. 28-ct. 12.... 16 2 Callao ...... June 30-Sept. 21... 6 ...... axmmarca-

Cutervo...... June 9-Aug. 17.... 5 ...... Chota...... June 30-July 27...... Present. LAbertad- Chiclayo...... Apr. 28-June 8.... 1 1 Salaverry...... June 4-Aug. 17.... 3 1 San Pedro...... June 4-Oct. 12..... 9 2 TrujUlo...... May 19-Oct. 12.... 13 ...... Lima...... do. 24 ...... Monsefu...... Oct. 612. 12 ...... Piurs ...... June 30-July 27...... Present. Catacaos...... Sept. 2-Oct. 6...... Piura...... do...... 1 ...... Phil' insIlands: ...... May 11-24...... 3 ...... Fourth quarter 1912: Cases '39; deaths, 33. First quarter 1913: Cases 8; deaths, 7. Second qusrter:..Cases, 9; deaths, 7. 1 Do...... Sept. 21-27...... Russia: Astrakhan...... 1 ...... i...... Aug. 2, 2 fatal cases. Tsarev...... fi...... June 310...... Pneumonic form. Acheozek...... Aug. 22...... 1 Diamantal-Toubek..... July 13-Aug. 17... 6 6 Breslavsk...... Oct. 3-19...... 5 5 Pneumonic. 7 Gromosaavsk ...... do. 11 Do. Kalatch ...... do. 5 4 Do. Novopetrovsk...... Sept. 26-Oct. 21... 35 35 Ralatch Estate...... Sept. 28-Oct. 16... 4 4 Voisko-Donsky...... Oct. 19-21...... 31 28 West Turkestan- Semihethji territory- Sept. 25...... 25 Lmong the Tourguen. Siam: Prvalskdistrct... B}...... Mar. 23-Oct. 4..... 1...... I KRorat...... Mar. 21-31...... Ppidemic. Straits ttem uts: June 15-21...... 1 I Tripoli

Derma ...... Prwmt. ... juay,July 1.515...... I.....;...... 1 ig. resent. Tripoli...... July 1-Sept. 3o30...... ii I ii-I December 12,1913 2710 CHOLERA, YELLOW FEVER, PLAGUE, AND SMALLPOX-Continued. Reperps Reived frmo Juwe8 to Dec. 5, 1918-omtinued. PLAGUR-CutitnUsD&

Places Date. Cae. Deths.

i Tur=9A la...Asia:Au 30...... 1 ..... B as ra.. July 1421 . 1 1 ToJune 331caes. TrebisondW.... Sept. 29-Oct. 4.... 11 2 In the Uruv%ay: prison. onvi deo ...... July 28, pre nt. SMALLPOX.

Algeria: Departments- Algiers...... May 1-July 31..... 11 . ..,...... Constantine...... 1-July 31.... 27...... Oran...... luayrAyr 1-July 31..... 59 ...... Arabia: Aden...... June 3-. 1.0 Do ...... Oct. 6-20...... 2 1 Argentina: 1111 Buenos Aires...... Apr. 1-July 31...... Australia: New South Wales...... I...... Total July 14Sept. 26: Caws, 829. Albury...... Sept. 12-26...... Sydney district, 810 cases. Cooah...... do......

Cootamundra...... Aug. 7-Sept. 26......

Goulbun ...... July 1-31...... nlabo...... Aug. 7-Sept. 11...... Hardon...... do. 1 ......

Litlhgow ...... July 1-31...... 1 ......

Liverpool...... Aug. 7-Sept. 11... 2 ......

Newcastle...... July 1-31...... Nyngan...... do...... Parkes...... do. 5 ...... Penrith ...... do. 2 ...... Sydney...... July 1-Sept. 11.... 721 ...... July 1-31...... 2 ......

Ulmsarra...... do. 2 ......

Sept. 12-26 ...... 1 ...... Queensland-

Brisbane ...... Aug. 7-Sept. 11...... IPs.h...... July 1-ept. 11.... 4 ...... Toowoomba...... July 1-31.... 1 ......

South Australia...... Jutly 17-Aug. 2.... 1 ...... Victorial-

Melbourne...... July 14 ...... 1 case on s. s. Karoola from Sydney. Austria-Hungary: Capodista...... Oct. 5-11...... 2 Coestland...... July 6-12...... 1 Decani...... Oct. 5-11...... 2 Fiume...... May 27-July 7..... 19 Galici...... July 6-Aug. 12.... 1 Gorz and Gradinska...... Aug. 7-14...... 1 Eranl...... do. 1 Trieste...... June 1-Nov. 1. 45 Cases June 14 from Patras. Tyrol and Vorarlberg...... Aug. 10-Oct. 25... 15 Belgum: - Antwrerp...... July 1-7...... 1 Brasl: Bahia...... May 11-Oct. 18.... 14 1 M ss...... June 15-21...... 1 ...... Para...... June 15-Nov. 8.... 77 30 Pernanbuco...... May 1-Sept. 30.... 250 Rio de Janeiro...... May 4-Oct. 18..... 34 British East Africa: Mombasa...... Mar. 1-June 30.... 29 9 Oanada: Provinosa- British Columbia- Vanoouver...... June 8-Sept. 13.... 2 ...... Manitoba- Winnig...... June 15-Oct. 18... 20 1...... Nova Sootfa- Sydney...... July 14-Aug. 2.... 2 1... Case July 14 from s. a Hartlepool fom Marmille- Ontario- Hamilton...... Oct. 1-31...... 3 Fort William...... June 10-30...... 4 Ottawa...... Jue S-Nov. 22.... 22 Toronto...... Jum 16-Aug. 2.... 9 2711 December 12, 1918 CHOLERA, YELLOW FEVER, PLAGUE, AND SMALLPOX-Contminued.

RePors Roeved from June 28 to Dc. 5, 1918-Continued. SMALLPOI-Contlnued.

Places. Date. Cusi. Deaths Remarks. 1..! Canad-Clontinued. ProvnasContud. Quebe- ram Quar- June 20...... 1 In steerae. taia I Quebec...... June8-Sept. 20.... 6 Montral...... July 8-Nov. 18.... 2 8t. Johns...... May 25July 5. 4 Chile: Iquiqu.. .. June 1-21. 2 June 18-29...... Prent. Aug. 16-Sept. 13, epl- demic. Vapaa...... July 12 ...... I...... Preset. China:Cb moy:...... May 25-June 7..... Do. d...... e...... May 251...... Do. Cbg...... Aug. 2...... Do. D b...... July 27-Oct. 20.. Ho...... ,...... Aug. 22, free. Hoy May 18-lune 14.

Na ...... May 11-8ept. 27...... Do. g...... May 19-Oct. 28.... 9 41 Deaths among natives. June 8-14...... I ...... 8-15 present in latzittan, Batavia...... Sept. Wnt.en...... Klatten and Soerkarta. DutchEastJava dl...... Batavia...... June 22-Oct. 18.... 28 a Spt. 8-29...... 78 PatJitta...... do. 15 ..... do. 637 71 Aug. 15...... 517 31 Surabay...... dris...... may 11-Oct. 11.... 16 8urabaya...... May 28-Nov. 4.... 26 2C Por EW ..ri...... 14lOct. 21.... 46 14 Port Said ...... Oc.1528...... 10 C..IL...... Sept. 1-0...... 21 Nantes Juns 23-29...... 1 wan"...... May 1-Oct. 31...... 142 Lso& ...... St.. mm...... Aug. 3-Nov. 1...... Toulon...... Pa ...... May 28-Oct. 25.... 27 St. E ne...... Sept. 21-Oct. 31... 4 ''''''''i ToHu ...... Aug. 18...... 1 ...... Germanl ...... Total June S-Oct. 4: Cases, 7. Aug. 24-30...... 1..... June 1-July 31.... 2 Stb..g...... Aug. 1-31...... Great Bitn: Hull...... BelEas...... Sept. 14-20...... India.Liarool...... May 25-Oct. 18.... B r ...... July 20-26......

Groee: ...... Patras...... June 9-Aug. 31.... 9 India:

Bombay...... y 2-Oct. 25.... 77 e8 Calcutta. ept. 13-27...... 2 ay25-Au . 16.. . 4 ay24-Octf. 4..... 31 13 Moulmkoe...... 30-June 28... 5 5 Do...... Aug. 3-9...... 1 1 Kipb...... May 1-ept. 30.... 51 20 Ttie...... Total Jan. 1-July 31: Cues, 87; oAn...... JulY 8-14...... 1 1 Italy: Naples..a...... Aug. 2-15...... 3...... Rome. Jan. -11...... Japan...... Total Jan. 1-July 31: Came, 87; 1...... deaths, 29. Hokado...... T8y...... Apr. 1- 0...... Kanegawa ken...... ASY 1-31...... 1...... Kobe...... Jas 23-29...... 1.....1...... Nagasaki ken...... may 1-July 31..... 54 14ii Oita ke...... My 1-June 30.... 11 4 Tokyo...... Jtue IS-Aug. 31... Aug. 18, epidemic. Yokam...... Aug. 19-25...... Luxembur: Ma? 17-31...... 2 ...... Malta...... Sept. 1-0...... 2...... Mlauritu...... Apr. 13-July 5.-. 1,019 i6i I Decmber 12, 1913 2712

CHOLERA, YELW FEVIR, PLAGUE, AND SMAIAL'OX-Contnued.

pors Rteceived ftout Jam 28 to Dec S, 1915-Continued. MLLPOIIContinud. Plae. Date. Cas. Deaths. Remarks.

Mexioo: May 25-Aug. 16...... 5 June 9-Nov. 9...... 36 2...... June 23-Nov. 13 <9huaheao...... anuco...... June 8-Oct. 18..... 80 ...... mxdaSa...... June 7-Nov. 3..... 128 Among troops. Otbotey...... ca July 18...... 86 Prsent. Dbwa...... Apr. 20-Oct. 4...... June 9-Ot. 26...... Pa uoo...... Oct. 12-18...... 13I ...... Purto Mex...... JSu1yt1-31...... ,1%t.-31...... San Luis Potosi...... Apr. 27-Oct.18.... . 13 SatiLto.l...o...... Aug. 1-June30.... 25 Vera crus...... June 16-Nov. 16... 5 Tamp po...... Sept. 16-Oct. 20... 3 2 Newfondland: ...... St. Johns...... June 15-Oct. 18... 39 Norway: Trndjem...... Oct. 1-31...... 6 ...... ~ Peru...... Sept. 30, epidemic in Ancon. Callao, Chancay, guao, an(i Lima. Bept. 27, uluprent in Ancon and Huaco. In Lima Jan. 1-June 30, 235 cases were admitted to the lazaretto. Philippine Islands ...... First quarter 1913: Cas, 5: . second quare, case, 63. Portual: L isbon...... May 25-Nov. 8.... 74 1...... 1. Rusa: Batoum .....; Apr. 1-May 31.... 4 ...... 1 Libau...... June 2-July 20.... 3 7 Mooco...... May 18-Nov. 1.... 93 27 Odema...... June 8-Nov. 1. 59 Rigi...... June 22-28...... 6 ...... St. Petersburg...... May 18-Nov. 1.... 34 Siberia- Vladivostok...... May 7June 20.... Warsaw...... Feb. 23-Sept. 20... 381863 ...... Samoa: Apis...... May 18, 1 death on tranport Mlchasl Jepon, from Hong- lcongadloJ~ ~ j r4, 4 cases rnferred from this vessel to aihter 3 miles east. Servia: Belgrade ...... June I-ept. 27.... 16 3 July 16, presat in Dubotzi, Ne- renitza, and Volul. Siam: Bangkok...... Mar. 23-Aug. 9.... Spain: Almeira...... June 1-Aug. 31.... 6 Barolona...... June S-Nov. 15.... 97 Cadle ...... May 1-Sept. 30. .. 5 Madrid...... June 1-Oct. 31. . 216 . ,...... Aug. 1-31...... 1 Sevillie...... July 1-31...... 1 Valencla. June 1-Oct. 25... Straits Settlements: Singapore. May 2 Switzerland: 4-Oct.11. Cantons- Basel ...... June 1-Sept. 20.... 37 ...... Zurich...... May 18-24...... 1 ...... From Paris. Turkey in Asia: Beir t ...... May 25-Nov. 8.... 106 53

Damascus...... June 1-7...... Present.

Marina...... May 25-July 12......

Apr. 26-Aug. 2...... 67 Turkey in Europe:

Constantinople. June 1-Nov. 8...... 84 Salonika. June 2-Nov. 1...... 68 Union of South Africa: Johannburg... May 10-June 7.... 23 ...... Urmguay: loitevi ...... wdeo Sept. 1-30...... 38 i West Indies: Trinidad. Aug. 19...... 2 On a. s. Danube and placed in quartine 5 mile dimnt. SANITARY LEGISLATION.

STAT UWS AND RGULTONS PETAINIG TO PUC HEALTEL

IDAHO. State Board of Health-Powers and Duties of-Bacteriologcal Stations. (Chap. 140, Act Mar. 12,1918M) (Section 1081, of House Bill 171, Session Laws of 1909, was amended to read a follows:) SEC. 1081. The board shall meet annually at Boise on the first Tuesday of October, and at such other times and places as they may deem expedient. A majority shall constitute a quorum for the tranaction of business. They shall choose annually one of their members to be their president, and may adopt rules and by-laws, subject to the provisions of this chapter. They shall have authority to send their secretary or a committee of the board to any part of the State when deemed necessary to investigate the cause of any epidemic or any special or unusual disosse or mortality. The boazd shall have power to establish such bacteriological stations within the State as they may deem necesary; to equip the same with the necessary laboratory apparatus and supplies; and to appoint a director for each station so established, who shall be a practical bacteriologist and who shall receive such compensation for his work as the board may prescribe, not to exceed $10 per day for each day actually and necessarily spent in bacteriological examination. Said compensation shall be paid on claims approved by the board out of any funds appropriated for the use of said board in the same manner that other claims against the State are paid: Provided, also, That when in the opinion of the State board of health the conducting of any test would be too expensive to be done free of charge the board would be allowed to charge a reasonable compensation for the same, such compensation to be determined by the board, and all such amounts collected shall be paid into the general fund of the State. County Boardg of Health-Organiation, Powers, and Duties- Health Offlcers (Chap. 140, Act Mar. 12,193.) (Sections 1095, 1097A, 1097B, and 1098 of House bill 171, Session Laws of 1909, were amended to read as follows:) SEC. 1095. Local boards of health.-The board of county commissioners must, biennially at their regular meeting in January, appoint a licensed physician residing in the county, who hall be known as the county physician. The board of county commissioners of each and every county in this State shall be constituted a county board of health for such county, and said county board of health's jurisdiction shall be coextensive with the boundaries of said county. The chairman of the board of county comm oners shall be president of the county board of health, and the county health officer shall be the clerk thereof. They shall, at their regular meeting in January, appoint a legally qualified physician county health officer, whose term 192 (2713) December 12, 1918 2714 of office shall be for two yea from January, next following each general election, and shall fix his compenation. The county health officer hball be ex officio member of the county board of health and ihall be the executive officer thereof, and may be or may not be county physician. The county board of health may appoint as many anitary officers as they deem necesary and fix the compensation of all appointees, who Shall serve during the pleaure of the board. Any vacary it such board caused by death, resignation of county health officer, or by his refusal to act, must be filled by appointment by the co mioners. The county board of health shall be empowered to make its own local rules and regulation% which shall not be incosiitnt with law nor with the rules and regulations of the State board of health, and must make and establish for the county or any disict or place therein such sanitary rules and regulations as they may deem necessary and proper to prevent the outbreak and spread of dangerous, contagious, and infectious disease, which rules or regulations shall take effect from and after their approval by the State board of health. When any locality is in need of a health officer, the secretary of the county board 6b health may appoint a local physician to act as deputy health officer, and the expenses of such deputy health offitler shall be paid in the same manner as all other county expense. Cities and villages and other localities, in which there is need therefor, may organize a local board of health to be composed of at lest one physician, who shall be the executive officer of such local board, and two other perons who may or may not be physicians. If, however, there is no physician residing in the city, village, or other locality, others may act. Such local boards of health shall act under the authority and direction of the county board of health for the county in which such city, village, or other locality may be situated, and shall report to said county board of health. All necessry expense incurred by the said county board of health in enforcing the provisions of this chapter must be paid for out of the general treairy from the current expense fund of the county, as other bilLs charge- able againstsaid current expense fund are audited and paid. Every health officer appointed under the provisions of this chapter shall be, whenever the same is practicable, a reputable physician licensed under the laws of the State of Idaho, and shall hold his office during the pleasure of the board and until his muccessor shall have been duly appointed and qualified; and in case of the occur- rence of a vacancy in his office, the board of health shall Mediately fill the same by a new appointment. So. 1097 A. InsspWti ofas.olo and pub1ic building.-It shall be the duty of all county boards of health to provide for the eamin ation by the secretay into the snitary condition of all county buildings and jails, school buildings, and other public institutions in the county, at least once every year, before the 1st day of May, and as nearsaid day as may be practicable, and such e mning officershall file a complete report, within 15 days aftersaid lst day of May, with the secretary of the State board of heilth. SEC. 1097 B. Quarantine counties.-The board of health of any county may declare qu tine therein or in any particular district or place therein, against the introduction of dangerous, contagious, or infectious disease prevailing in any State, county, or place, or of any or all persons and things liable to spreadsuch dangerous, contagious, and infectious disease. Thesaid county board has authority and power to enforce such quarantine until the same is raised by themselves, and may confine such inflicted person or persons liable to spread suchdangerous, contagious, or infectious disease to the house or premise in which he or she resides, or, if deemed advisable, to a place to be provided for them for that purpose. And when any contagious or infectious diseas shall, in the opinion of the State board of health, become or threaten to become epidemic in any city, village, or county, and the local authorities shall neglect or refuse to enforce measures which, in the opinion of the State board of health, are efficient for its prevention, the State board of health, or its executive officer, on the 2715 December 1Z, 1913 ordw o the nt of said boa, may appoint a medial or sanitay officer, and sc as ae w require, and -tie him etfoc much order or rn6o Ia as said bard mints exacutive ofir may. dea ne ry, the expens thereof to be paid by that iplit or county in which such wvices we rendered out of im genel fund. The term "d , conbgio, o infctios diea" sall be condtred and understod to mean sch diea or diseas as the State board of health shal d e as contio or infectious and dangeos to the public health. Bgr. 109. Duti. of haet ofr.-It shall be the duty of every county helth ofeer, ediately after his amp intment, to tranmit to the secrry of aid board of haldih his ful name and post-office addres; he sha keep accurate record of the p eedhgs of the bocal boad of which he is the ry, as well as his own offia acsb, and fnmish a report thereof monthly to the tary of the State board of heIth: Provid, homr, That any epidemic shall be re immediely, toet with suh other infomtion in regard to the saniary condition of his jurisdiction a he may dem interesng or valuable for publication in the annual report of the tate board of health. He shall recive for his sics as health offcr such resonuble compensation as his board may allow to be paid out of the county tresury, this compensation to be fixed sparately frm that of the county physician; and for every bilure or nelect of mid health officer to perform any of the duties pre- scrbed in this act, he shall be held guilty of a misdemeaor. Every municipl or local hlth officer shal make a simibr report a required by the county health officer to the cretary of the county board of health. Any health officer who shall refuse or neget to obey or enforce the rules or regulations or orders of the State board of health or who sal refuse or n%eet to make prompt and accurate reports to the State board of health may be removed as health officer by the State board of health, and shall not again be r ed except with the conset of the- State board of health. Any eer of a city or county board of health who shall violate or reuse or neglect to obey or enforce ay of the rue, regulations, or orders of the Sate or county boards of heath made frtho n s , or control of any dangerous, cgious, or infectih s d se, or for the protetion Of the halth of the people of this State, sal be guilty of a I o, and upon to shall be fed not les than $10 nor-me than $, and shall b emoed f offe. CommunIcable Disease--NeII&aon of Cases o Q D Schoels-.DlapoeaI of Bodes (Chap. 140, act Mr. 12, 1918.) (Section 1099 of House bill 171, Sesion Laws of 1909, and sections 1100, 1102, 1104, and 1106 of article 3, chapter 1, of title 3, Political Code, Revised Codes of Idaho, were amended to read as follows:) SzC. 1099. Physician8 to report certain diseaes.-Any physician or other person called to attend any peron who is suffering from smallpox, cholera, plague, yellow fever, typhus fever, diphtheria membranous croup, arlet fever, typhoid fever, infautle paalysis and cerebrospinal meningtis, or any other dies dangerous to the public health or required by the State board of health to be reported, shall report the name within 24 hours to the health officer within whose juridiction such person is found, giving in such report the name, age, sex, and colorof the patient, and the house or plac in which such person may be found; and in the case of smallpox, cholera, plague, yellow fever, diphtheria, membranous croup, scarlet fever, or infantile paralysis and cerebrospinal meningitis, the attending physician shall at once declare a temporary quatine, and shall prohibit entrance to or exit from such house; such temporary qu tine to remain in effect only until such time as the proper health officer ca be notified and can act in the matter. In like manner it shall be the duty of the head of the family, and of the owner or agent of the owner of the building in which a person resides who ha any of the disea herein named or provided against, December 12, 1913 2716 or in which ae the remains of a peron having died of any such diseas, immediately -after becoming aware of the fact, to give notice thereof to the health officer. When complaint is made or a reasonable belief exist that an infectious or contagious disease prevails in any house or any other locality which has not been reported as hereinbefore required, the board Shall cause such house or locality to be inspected by its health officer, and disoovery that such infectious dise prevails in any hous or any other locality which has not been reported as hereinbefore required, the board Shall cause such house or locality to be finpected by its health officer, and on discovering that such infectious or contagious dise exists, the board may, as it deems best, send such person to a quarntine hospital or other place provided for such persns, or may restrain them or other persons exposed within aid house from intercourse with other persons, and prohibit ingres and egres to or from such premiss. Any peron, on whom a duty is imposed by the provisions of this setion, who fails, neglects, or refuses to perform the same as herein required, and any persons who violates any regulation of the physician attending a person afflicted with any of the diseases above mentioned, dsll be deemed guilty of a misdemeanor, and on conviction thereof, shall be fined a sum not exceeding $50, or be imprioIned in the county jail not exceeding 90 days, or shl suffer both fine and imprisonment. SEC. 11l0. Quarantine of infected houe8.-It shall be the duty of the local board of health, when a case of smallpox, cholera, plague, yellow fever, typhus fever, diphtheria, membranous croup, scarlet fever, infantile paralysis, and cerebrospinal meningitis or any other dangerous, contagious, or infectious disease is reported within its juisiction, to at once cause to be placed, in a conspicuous position on the house wherein any of the aforesaid diseases occur, a quarantine card having printed on it in large letters the name of the disease within, and to prohibit entrance to or exit from such house without written permission from the board of health. No person quarantined by a board of health on account of having a contagious diease, or for having been exposed thereto, shall leave such quarantined house or place without the written .permission of the board of health. Every physician attending a person affected with any of the aforementioned disae shall use such precautionary measures to prevent the spread of the disease as may be required by the board of health. No persons shall remove, mar, deface, or destroy such quarantine card, which shall remain in place until after the patient has been removed from such house, or has recovered and is no longer capable of communicating the disease, and the said house and the contents thereof have been properly purified and dsifected under the direction of the board of health; and where other inmates of said house have been exposed to and are liable to become ill of any of said diseases for a period thereafter, counting from the comple- tion of disinfection as follows, to wit: In diphtheria and membranous croup, 14 days; in mallpox, 17 days; in scarlet fever, 10 days; in cholera or yellow fever, 7 days; in typhus fever, 21 days. In cases of measles, chicken pox, and whooping cough, or either of them, the board of health may require the same report of cases, and may enforce the same quarantine and other preventive measures, as are provided for in this chapter in case of scarlet fever. The board of health may employ as many persons as it deems necessary to execute its orders and properly guard any house or place containing any person or persons affected with any of the diseases named herein, or who have been exposed thereto, and such perns shall be sworn in as quarantine guards, shall have police powers, and may ue all necesary means to enforce the provisions of this chapter for the prevention of contagious or infectious diseases, or the ordeis of any local board of health made in pursuance thereof. Any person on whom a duty is imposed by the provisions of this section who fails, neglects, or refuses to perform the same as herein required, shall be guilty of a misdemanor, and on conviction thereof shall be fined a sum not exceeding $50, or be imprisoned in the county jail not exceediug 90 davs, or shall suffer both fine and imprisonment. 2717 Dsmber 12, 1913 SzC. 1102. Disinfetion of houw.-When the health authorities of any county or municipality are of opinion that the cleasng and disinfection of any house or part thereof, and of any articles therein likely to retain infection, would tend to prevent or check infectious dises, it shall be the duty of such authority to cleanse and disinfect such house, or part thereof, and articles, and the health authorities may recover the expenses incurred from the owner or occupant: Provided, That where the owner or occupant of any such house or part thereof is, from poverty or otherwise, unable, in the opinion of such health author;ty, effectually to carry out the requirements of this section, such authority may cleanse and disinfect such house or part thereof, and articles, and the municipality or county in which said house is situated shall defray the expenses thereof. SEC. 1104. Exclu8ion of exposed persons from 8scools.-No peron residing in or occupying any house in which there is a person suffering from smallpox, cholera, plague, typhus fever, diphtheria, membranous croup, chicken pox, measles, mumps, whooping couigh, or scarlet fever, cerebrospinal meningitis, infantile paralysis, shall be permitted to attend any public, private, or parochial school or college, or Sunday school, or any other public gathering, until the quatine provided for in such diseas in section 1100 has been removed by the board of health. All school proncipals, Sunday school superintendents or other persons in charge of such schools, are hereby required to exclude any and all such persons until such time as they may present a written permit of the local board of health to attend or reenter such chools. SEC. 1106. Caeatiom and burial of bodies.-The bodies of persons who have died of smallpox, cholera, plague, yellow fever, typhus fever, diphtheria, membranous croup, scarlet fever, cerebrospinal meningitis, infantile paralysis, or other dangerous contagious or infectious disease, shall be buried or cremated within 24 hours after death, unless written permision to the contrary be granted by the board of health; and no public or church funeral shall be held in connection with the burial of a per- wn who has died of any of the above-named diseases, and the body of any such person shall not be taken into any church, chapel, or other public place, and only the adult members of the family and such other persons as are actually necessary shall be present at the burial or cremation of the body. Water and Ice-Prevention of Pollution of. (Chap. 173, Act Mar. 13,1913.) SETION 1. Ice offered or intended for public use or consumption shall be kept stored in clean places free from all filth, offal, refuse, and polluted waters and sepaate and removed from contact with animal or vegetable matter, and not in proximity to any ceaspool, privy, vault, or sewer, nor in places where such ice may be subject to the containtion from, or the action of, acids, oils, noxious, offensive or injurious gase, smoke or vapors; and all ice kept or stored in violation of this section shall be deemed polluted ice and not fit for human consumption; and it shall be unlawful to sell, offer for sale, or store for sale such polluted ice. SzeC. 2. That any corporation or person owning or maianing any plant or system for the supply to the inhabitants of this State, or any part thereof, of water for domestic purposes shall keep the same clean and free from all impurities, accumulation of sediment, offal, refuse, dead animals, and all other foreign substances which tend to injure the health of the consumers of such water. Any peon or corporation failing or neglecting to comply with any of the provisions of this act sihall be guilty of a misdemeanor. Births and deaths-Registration of. (Chap. 39, act Mar. 1, 1913.) SEcTION 1. That section 7 of chapter 191, Session Laws of Idaho, 1911, be amended to read as follows: SEC. 7. That the certificate of death shall contain the following items: Deceusber 12, 1913 2718 1. Plre of death, including Sae, county, townsip, city, the ward, sreet, and house numbe. If i a hpl or ete itutiWtite, the naw of the e to be gven insded of the Areeit and house number. If in an industrial camp, the me of the camp to be given. 2. Full name of decedet. If an unname child, the s preceded by "un- named." S. Sex. 4. Color or race-as white, black (negro or negn dsceut), Indian, Chinse, Japa- noese, or other. 6. Conjugal condition-as single, married, widowed, or divorced. 6. Date of birth, including the year, month, and day. 7. Age, in years, months, and days. 8. Place of birth; State or foreign country. 9. Name of father. 10. Birthplace of father; State or foreign country. 11. Maiden name of mother. 12. Birth of mother; State or foreign country. IS Occupation. The occupation to be reported of any person who has any remu- nertive employment, women as well as men. 14. Signature and addreu of in t. 15. Date of death, year, month, and day. 16. Statement of Medical _e-s ncee ondecede1t, fact and time of tsth, time lst seen alive. 17. OCae of death,icldn the p ar d oonWibutryaumn-orm ons, if any, and duration of ach. 18. Signe and addre of physician or offiial the media C e. 1,. Length of eidence at place of death and in Sate. Special inlouatiom cuon- cerning deatbe in hospitals and indtitions, and of peons dying away fom home, including the former or usal resdence, and place whre the dise was contracted. 20. Place of burial or removal. 21. Date of burial or removal. 22. Signature and address of undertaker. 23. Offiial signature of reitra, with the date when certificate was fld, and registered number. The pernal and statisical particulars (items 1 to 13) shall be authenticated by thre signature of the informat, who may be any competent person acquainted with the facts. The statement of facts relating to the disposition of the body shall be signed by the uudertakeror peron acting as such. The medical certificate shall be made and sned by the physician, if any, last in attendanoe on the decesed, who shall specify the time in 4ttendance, the time he last saw the deceased alive, and the hourof the day at whichdeath occurred. And he shall further state the cause of death, so as to show the course of disease or sequence of causes resulting in death, giving the primary cause, and lso the contributory causes, if any, and the duration of each. Indefinite and unstifactory terms, indicating only symptoms of disease or conditions resulting from disease, will not be held sufficient for issing a burial or removal permit; and any certificate containing only such terms as defined by the State registrar as indefinite and unstictory, shall be returned to the physician for correction and defini- tion. Causesof death, which may be the result of either disea or violence, shall be carefully defined; and, if from violence, its nature shall be stated, and whether (probably) accidental, uicidal, or homicidal. And in cas of deaths in hospitals, institutions, or away from home, the physician shall furnish the information required under this head (item 20), and shall sgtate where, in his opinion, the disas was contracted. 2719 December 12, 1913 8Sw. 2. That section 20 of chapter 191, Sesson Laws of Idaho, 1911, be amended to read s filolews 8S;. 2U. ThsteaClog Itrahallbeentitledto be paidthe um of 25 cnts for each bit and each death certificate properly and completely made out and registered with bim, and corectly copied snd promptly returned by him to the State regie- traY, a rquired by this act. And in case no birth or deaths were regitered during anymo.nth, th lo regisrahall be entitled to be paid thesume of 25 cents for each repoxt to that efect, promptly made in accordance with this act: Provided, howerer, That ompenstion for such services may be fixed by the city council, or other governing body of such city, incorporated town, or registration district. All amounts payable to registrars, outside of cities or incorporated towns, under provisions of this section habl be paid by the treaurer of the county in which the registration districts are located, upon certi&cation by the State registrar. And the State registra shall annually certify to the treasurer of the several counties the number of births and deaths regisered, with the names of the local registrs and the amounts due each at the rates fixed herein: Providd, however, That no warrant shall be issued to any local registrar where notice is previously given by the State registr to the auditor, city clerk, or other proper officer of such registration disrict that the local registrar has failed to comply with the rules and regulations of the State board of health and bureau of vital ststics and the instructions of the State registrar. KANSAS. State Board of elth-rtI EZuqoyes Atherid (Act Ma. 17, 1)13.) SEC. 9. That section 9021 of the General Statutes of Kansa of 1909 be amended to read as follows: "SEC. 9021. That the State board of health is hereby authorized to appoint a clerk who- sball be a stenographer, who shall receive an annual salary of $900; a stenographer who hall receive an annual salary of $900; and a bacteriologist who shall receive an annual salary of $1,200." SEC. 10. That section 3085 of the General Statutes of Kansa of 1909 be amended to read s follows: "Szc. 3085. The State board of health shall appoint three food inspectors and two drug inspectors who shall serve during the pleasure of the board, and shall each receive a salary of not more than $100 per month for the first year of service, $110 per-month for the second year of service, sad $125 per month thereafter. The secretary of the State board of health all appoint, upon recommendation of the State board of health, an assistant chief food and drug inspector, who shall receive a salary of $150 per month, ndwho shall serve during the pleasure of the chief food and drug inspeor. They shall be allowed the actual necesry expens incurred in the perfornace of their duties, which shall be such as re' prescribed by the rules of the State bear of health, as hereinbefore provided. The appointment of the inspectors herein provided shall be based upon a competitive examiuation of applicants upon the position of inspector, which examination shall be conducted by the chief food and drug inspector, and the food and drug anlyst of the State board of health. The scretary of the State board of health, " executive officer of the board, shall direct the aciaos of the food and drug inspectors assuch, and by reason of this office shall be chief food and drug inspector. He shall receive a salary of $2,500 per annum and such neceary expens. as are incurred in the performance of his duties a secretary of the State board of health and chief food and drug inpector." Vasectomy and Oophorectomy-When Authorized. (Act Mar. 14, 1913.) SmCoNo 1. That it shall be the duty of the managioff of all public inutions of thistate inatustd with the cae or custody of hail criminas, idiots, epileptics, imbecile, and insne, and they are hereby authoized and directed to obtain the December 12, 1913 2720 advice and profemional services of competent surgical aia , who, jointly with the physician or surgeon in charge of the inttution in which any of sch inmates shall be, shall constitute the authority whose duty it shll be to examine such inmate or iamates of the several institutions as are deemed to be improper and inadvisable to allow to procreate; Such authority shall examine the physical and mental condition of such inmate or inmates, the history thereof so far as can be ascertained, and if, in the judgment of such authority, procreation by any such inmate or inmates would produce children with an inherited tendency to crime, insanity, feeble-mindedness, epilepsy, idiocy, or imbecility, and there is no probability that the condition of any such inmate or inmates as examined will improve to such an extent as to render procreation by any such inmate or inmates advisable, or if the physical or mental condition of any such persons will be materially improved thereby, then said authority shall report their conclusions with a recommendation to the district court or any court of competent jurisdiction in and for the district from which such inmate or inmates has been comn- mitted to sich institution or institutions. The court Shall thereupon hear and determine the matter, and if satisfied that the purposes of this act will be executed by such order shall adjudge that such operation shall be performed, and shall appoint one of the authority signing such report to perform the operation of vasectomy or oophorectomy, as the case may be, upon such person. The county attorney of the county in which the hearing is had may be directed by the court to represent the State in the proceed. ings. Such operation shall be performed in a safe and humane manner, and the sur- *geon performing the operation all receive from the State such compensation for the service rendered as the board of administation shall deem reasonable. SEC. 2. Except as authorized by this act, every person who shall perform, encour- age, assist in, or otherwise promote the performance of either of the operations described in section 1 of this act, for the purpose of destroying the power to procreate the human species, or any person who shall knowingly permit either of such operations to be performred upon such persons, unless the same shall be a medical necessity, shall be fined not more than $1,000, or imprisonment in the county jail not exceeding 1 year, or both. SEC. 3. Any managing officers herein charged with any duty specified in section 1 who shall fail, neglect, or refuse for 60 days or more in the performance thereof shall be guilty of a misdemeanor and subject to a fine of not more than $100 or imprisonment in the county jail for not more than 30 days, or both such fine and imprisonment. MONTANA. Milk and Milk ProduetsProduction, Care, and Sale. (Chap. 77, Act Mar. 13,1913.) SEC. 3. Duties of the State dairy omissoner.-It shall be the duty of the said State dairy commissioner or his deputies to inspect or cause to be inspected all creameries, dairies, butter, cheese, condensed milk, or ice cream factories, or any place where milk or cream or their products are produced, handled, or stored within the State at least once a year or oftener, if posible. It shall be the duty of the said dairy commissioner to act upon all reports or complaints that he may receive from owners and managers of public dairies, creameries, butter, cheese, condensed-milk and ice-cream factories, or other persons, wherein it is reported to him the names and locations of one or more producers of milk, cream, butter, cheese, condensed milk, or ice cream who are offering for sale milk, cream, butter, cheese, condened milk, or ice cream that is not fresh and clean, and in such instance he may inspect barns or faxm houses, creameries, factories, or other places where dairy products or utensils are produced, kept, stored, handled, or sold, and he may give advice and instruction in the proper performance of the work, and he may probibit the sale of unclean or unwholesome milk, cream, butter, cheese, condensed milk, or.ice cream. It shall be his duty to condemn for food purposes all unclean or unwholesome milk, cream, butter, cheese, condensed milk, or ice cream wherever he may find them. 2721 December 12, 1913 This is to include all dairy products produced or manufactured where proper rules of sanitation are not observed. That where he condemns unclean or unwholesome dairy products said products must be so treated as to render impossible the manufacture or renovation of such products for human food. That he shall in all cases where he finds that the law as herein provided has been violated, it shall be his duty to so inform the county attorney where the violation has been committed, and that sid county attorney shall then investigate the charges of violation of this act made in his county and to prosecute all cases where evidence of guilt is shown. * * * * * * * The said State dairy commissioner and his deputies are hereby authorized, and it shall be his duty to enter at any time all creameries, public dairies, cheese, condensed milk, and ice-cream factories, or other places where dairy products are manufactured, produced, stored, or kept for sale or transportation, for the purpose of inspecting the same; to take samples anywhere of dairy products, or imitation thereof, suspected of being made or sold in violation of the law, and cause the same to be analyzed or sat- isfactorily tested by the chemist of the State pure food department. That the sample taken as above prescribed shall be taken in duplicate and one of the same delivered to the manufacturer of the dairy product so sampled. Due notice in writing shall be given to the manufacturer of the date and hour on which a sample will be tested or analyzed by the chemists of the State pure food department so that the manufacturer or his representative may be present at such test or analysis. The State dairy commissoner or his deputies shall have the power to examine under oath or otherwise, any person whom they believe has knowledge concerning the violation of any provision of this act. The said State dairy commisioner shall make an annual report to the governor not later than January 1 of each year. SEC. 4. For the enforcement of the sections of this act "sanitary" will mean that all creameries, dairies, butter, cheese, condensed milk, or ice-cream factories, or any place where milk, cream, or any of their products are produced, handled, or stored within the State shall score as much as 65 per cent of the Government score card or modifications thereof, suitable to the conditions of Montana. Each inspector or person authorized by the State to make such inspection shall leave the owner or proprie- tor a duplicate of score card. All barns, stables, or other buildings in which dairy cattle are housed or stabled shall be of such proportion as to allow 350 cubic feet of air space for each and every cow therein. All such buildings must be lime washed throughout at least once every year and have 2 square feet opening for every animal stabled therein, but the specifi- cations as herein prescribed shall not be deemed to apply to persons who milk but five cows or less. All manure accumulating in such buildings to be removed at least once every 24 hours, and during the months May to September, inclusive, of each year, must be deposited at a distance not less than 50 feet from such buildings The State dairy commissioner shall keep a record of each inspection with the address of the premises inspected, and shall record the number of cows kept and the quality of dairy products handled. SEC. 5. Deftnition.l-Milk is the fresh, clean lacteal secretion obtained by the complete milking of one or more healthy cows, properly fed and kept, excluding that obtained within 15 days before and 5 days after calving, and contains not less than 8.5 per cent of solids not fat, and not less than 3.25 per cent of milk fat. Adulterated milk is milk containing more than 88 per cent water and less than 11.75 per cent of total solids, 8.5 per cent solids not fat, and 3.25 per cent fat, except milk for manufacture; milk which has been diluted with water or into which has been introduced any foreign substance whatever. This includes all substances added for t;he purpos of preserving, coloring, and thickening milk or , or milk handled an insnity maner. Deoember 1Z, 1913 2722 Crm is that portio of milk, rch ia lk, which ris to the surfac of milk on lag, or s p hd fom it by osiul ce, eh ad cla, aWd co- Wm MtI h 20 PaFWof mgk Butter is the ln cc a ilk ul milk or crea with or without the additin of it or mr, co less the &.5 per cent of butter ist and sot tha 16 per ot water. Cheese is thW sound, lid, ad ripened p At madeo om milk or cram by eeagu- lating the cae"in thereof with remnet or lactic acid, with o without the addition of ripening ferments, aoning, and coloring matter, and contains, in the water-free nce, not la than 60 per cent of milk fat. Ice crm is a froseu prOduct Mde fm cream, glati, and sgar, wit or without flavoring, and coNain not 1.. than 14 per eent of milk fat sad not moe than 1 per cent pure gelatin. Oleom ine butterie, imitation butter, or imitation chse an uan ade in imitation of butter or chems, but not entirly fm pu milk or cream in the usual way. They may be constred to mean any artic b into which ay oil, lard, or fat not produced milk or cream enters As a component pert Ssc. 6. Adua ilk.-No person sha 11 Or exchane or ofier or expos for 1e or exchange milk or crea any unclean, iMpure, adulerated, or unwholesome milk, or unlea, impure, adulteted, olored,or unwholeme milk or cream, or sell or exchnge, or oiler or expose for sl or e, any substace in imiation or semblce of milk or crem whicl is t milk or ea, aor shall they ell or exchage, or ofler or expos for *de or e4xchanp, may suck Ubn d for milk or cream, or sell or exchange, or offer or expose for l or excae, any icle of food made fhm such milk or crem, or manufacUre fuay guch milk or cream any article of human food. Any person deliveng milk or cream to any butter or chees fctry, coedn ilkathing stion, or ailwy sttion to be shpped toany city, town, or vilge shaUl be deumed to exPseordwtbhamo fwae whther the said milk or crem ia s to uisieU or anoter. Fah and very ca thus delivered, bipped, or grmd, if it be not Ps. milk rcram, must ber a label or card upon wick hall be plinly and Iqiby stated tke cntit or ients of the contnt4 of te cm. Then da be o lmit to the pecelaeoaf fa contained in unadulterated milk or cream sold to creameries for the sole purp of c- ture into butter. Suc. 7. Mfll, aw_u, or i-cr.m ewls.-4e pm or pers sal, without the consent o de owner or Owers, e, sell, dipose ofr traffic in any milk ams, jar bottles, or milk or ur-crem pueptales beogift to any dear oir hipper o mailk or milk productA having the nam or initials of die owner on suc cans, jam, bottles, or other receptacles. No person shall willfully mar, change, or erae the z&me or inidals staped or fastened upon seled milk receptacles or vesls for other purpses, nor place any othr substac ha milk or its prDduct in them. Cleaning ves8els WforC rtum.-iWhenevw any cuan, vesl, or other reoptacles used in the tanportaion of milk, cram, of thei prod ts& ar retured to the pro- ducer for a frd spment of the poduct, tey must be thoroughly claned by wash- ing, rinsing, and scalding, so as to make their condition saniry and stable as a rceptacle for beh mil d reamor teir products. N peson sall place orsuffer to be plced in any such cn or rept any g, dirt, filth, or ay animal or vegetable subste tendin to pduce or promot an inaniary coadition. Milk, cream, or ice crem shll nt be handled in ans swtd inide. SEC. 8. Iitar plae d appMass for mik.-No prsn Esh11 p e or keep milk or any of its pducts inteaded for sale or exceplace whlere conditiosare inaiaryayS uuvorBle to thre psoduetiopof wolesme foods. 8Sw. 9. ButIf and .ice/svofwm.Opsst fail OopoMtv b,tter, hees, and condensed-milk ories keep their bo eporis ion of any p&ton at all times, showing the daily amounts of milk and cream received and the pe cent and 2723 December 12, 1913 amount of fat in the mil and crem receivied from each patron, and the amounts of cream sold and butter, cheese, or condensd milk manufactured daily. Every facility should be offered to the patron for keeping himself informed in regard to the businew of the buttcr, ch_e, ad condened-milk factory, and checking up his daily product with his returns. Sw. 10. Reportinfictoein.-It shall be the duty of every cheese factory, creamery, butter and s-milk. icty, or skimming station in the State, where milk is purchsed or contributed by twree or more perons, to register the location of such cheese factory, creamery, butter or condensed-milk- factory, or skimming station, and the name of its owner or mager with the dairy commioner on or before the 1st day of April of each year. Before the orgnization of any new factory notice shall be given at once to said dairy commissioner. NEVADA. County Remh Officers-Applatment, Power, and Dutles -(Chap. 103, Act Mar. 15, 1913.) SzecioN 1. Section 6 of the act of March 27, 1911, is hereby amended so as to read as follows: "Szc. 6. The board of county commissoners shall appoint a local health officer for a period of not le than one yeaz who shall only be removed for incompetency, and who Shall act as a collector of vital attiticsnd is empowered to appoint such deputy or deputies as may be necewy, ith the approval of the board of county commis- siones. For colle and compiling the vital statistics of the county, he Shall receive from the county a auw, not lea than $25 per month, and the board of county commimioners are directed to allow a claim for this or for such greater sum as they may deem proper for the work performed; the deputies appointed by the local health officer, with the approval of the county com ioners, hall be paid in the same manner, a sum not to exceed $25 per month for registering and compiling the data prescribed by the State board of health and by this act. The deputy health officers shall file with the loCal helth officer monthly reports not later than the 5th day of each month, which said report shall be compiled by the local health officer and forwarded to the secretary of the State board of health not later than the 10th day of each month. In counties where deputy regirars are appointed the county commissoners shall allow them a monthly salary, or the sum of $1 for each birth and death certificate executed by them." Communcab Dl_e-No ffcatm of Cases of-Rep of Ma%ges. (Cp. 1038, Act Mar. 15, 1913) Sac. 2. Following ectioa 24 the following sections are to be instertd: "Szc. 25. A case of smallpox, diphtheria, an4 scarlet fever shall be reported by the attending physician to the local health officer within 24 hours after making such diagosis, and on or before the 5th day of each month physicians shall report to the local health officer in their respective counties all cases of contagious, infectious, or communicae diease treated by them during the preceding month. Blanks for such reports shall be supplied by the State board of health. "Sac. 26. Any physcian who ahall willfully neglect or refuse to perform any duties imposed upon them by the provisions of this act, shall be deemed guilty of a misdemeanor, and upon conviction shall be fined not les than $5 nor more than $25. "SEc. 27. It shall be the duty of the county clerk, of the several counties of the State, to tansmit to the iecretary of the State board of health, on or before the 10th day of January and the 10th day of June of each year, the number of marriage licenses issued by him during the preceding six months. "SaC. 25 of said act to be renumbered and known as section 28, and the following sections numbered consecutively up to and including section 33." Deceber 12, 1918 2724 NEW PRE. Sal for Stae Board of Health (Chap. 29, Act Mar. 14,1913.) SNolON 1. The State board of health shall have a seal, which shall be like the present seal of the State except that the device thereon shall be surounded by the words "State Board of Health of New Hampshire" in the place of the words "Sigillum Reipublicse Neo Hantoniensis, 1784 " surrounding the device of msid seal of the State. Every certificate or other official paper executed by the secretary of the State board of health in pursuance of any authority conferred by law, and bearing the seal of the board, shall be received as evidence, when duly certified by the secretary of said board under its seal, with the same force and effect as the original would, in law, be entitled to, if produced in open court. NORTH CAROLINA. Health Authorite-Control of Communicable Diseases-Water Supplis (Chap. 181, Act Mar. 12, 1913.) (Chapter 62, Public Laws of 1911, was amended to read as follows:) SEoroN 1. State board of health, how elected.-The medical society of the State of North Carolina shall choose from its members by ballot four membe and the governor of the State shall appoint five other persons (one of whom shall be miitarywgineer), and they shall constitute the North Carolina Board of Health. SEC. 2. Term of office; vacnes, how filled.-The members of the board of health elected by the State medical society shall be chosen to serve for six yeW' Their term of office shall begin immediately upon the expiration of the meeting st which they were elected. Those appointed by the governor shall wrve for six their term of office beginning with the fint regular meeting of the board after theirdlpoint- ment. In case of death or resignation, the board shall elect new members to fill the unexpired terms: Provided, The governor shall fill such vacancies as may occur where he has made appointments. SEC. 3. Duties of the State board ofhealth.-The board of health sall take cognizance of the health interests of the people of the State; shall make sanitary invstigtions and inquiries in respect to the people, employing experts when necesry; shall investigate the causes of diseases dangerous to the public health, especially epidemics, the sources of mortality, the effect of locations, employments, and conditions upon the public health. They shlil gther such information upon al these matters for distribution among the people, with the especial purpose of informing them about preventable diseases. They shall be the medical advisers of the State, and are herein specially provided, and hall advise the Government in regard to the location, sanitary construction, and managment of all State institutions, and shall direct the attention of the State to such sanitary matters as in their judgment affect the industries, prosperity, health, and lives of the people of the State. They shall make an inspection once in each year, and at such other times as they may be requested to do so by the State board of charities, of all public institutions, including all convict camps under the control of the State's prison, and make a report'as to their sanitary condition, with suggestions and recommendations, to their respective boards of directors or trustees; and it shall be the duty of the officials in immediate chwage of said institutions to furish all facilities necesary for a thorough inspection. The secretary of the board shall make biennially to the general asembly, through the governor, a report of their work. Saz. 4. lKay make regulations in times ofepidemics.-In times of epidemics of sanll- pox, yellow fever, typhoid fever, scarlet fever, diphtheria, typhus fever, bubonic plague, and cholera the State board of health shall have sanitary jurisdiction in all cities and towns not having regularly organized local boards of health, and are hereby 2725 Decmber 12, 1913 empowered to make all such regulations as they may deem necesary to protect the public health, and to enforce them by suitable.penalties. Sw. 5. Bulktins of diease isued; rule made to cecI diseae; pay of embersfor.- Bulletins of the outbreak of dise dangerous to the public health shall be isued by the State board, whenever necessary, and such advice freely disseminated to prevent and check the invasion of diseas into any part of the State. It shall also be the duty of the bard to inquire into any outbreak of dise, by personal visits or by any method the board shall direct. The compensation of members on such duty shall be $4 a day and all necesry traveling and hotel expenses. SEC. 6. Offiers ofN salary of 8ecretary; pay of mrember8.-The State board of health hall have a president, a secretary who shall also be twasurer, and an executive committee, said executive committee to have such powers and duties as may be asigned it by the board of health. The president shall be elected from the members of the board and shall serve six years; the secretary-treasurer shall be elected from the registered physicians of the State and shall serve six years. The executive committee shall be composed of the president of the board, ex officio, and two other members of the board to be elected from those composing it. The executive office of the board shall be in the city of Raleigh, and the secretary shall reside there. The secretary shall be the executive officer of the board and shall, under its direction, devote his entire time to public-health work, and shall be known as the "State health officer." He shall receive for his services such yearly compensation as shall be fixed by the board, not to exceed $3,000, and his actual traveling and hotel expenses when engaged in the work of the board. The board may in its discretion elect as a special assistant to the State health officer, for the antituberculosis work, the secretary of the State Asociation for the Prevention of Tuberculosis, at an annual salary not to exceed $600. The members of the board shall receive no pay, except that each member shall receive -$4ld necessary traveling and hotel expenses when on actual duty in attending the etings of the board or of the executive committee or in pursuing special inv in the State; but when attending important meetings beyond the limits of tb6te, the number of delegates thereto being limited to one, in addition to the sbry, only actual traveling and hotel expenses shall be allowed. These sums abte paid by the treasurer on authenticated requisition, approved and signed by the president. SEc. 7. Time of meeting to elect offers.-The meetings of the State board of health for the election of officers shall be on the second day of the annual meeting of the Medical Society of the State of North Carolina in the year .1901 and every six years thereafter. SEC. 8. Time of special and regular meetings.pecial meetings of the State board of health m,ay be called by the president through the secretary. The regular annual meeting Shall be held at the same time and place as the State medical society, at which time the secretary Shall submit his annual report. The executive committee shall meet at such times as the president of the board may deem necessry, and he si all call such meetings through the secretary. SEC. 9. County board of health, who constitutes; election of county physician or county health oer.-The chairman of the board of county commisioners. tle mayor of the county town, and in county towns where there is no mayor the clerk of the superior court, and the county superintendent of schools shall meet together on the first Monday in April, 1911, andthereafteron the first MondayofJanuary in the odd years ofthe calendar, and elect from the reguarly registered physicians of the county, two physicians, who, with themselves, shall constitute the county board of health. The chairman of the board of county commissioners shall be the chairman of the county board of health, and the presence of three memibers at any regular or called meeting shall constitute a quorum. The term of office of members of the county board of health shall terminate on the first Monday in January in the odd years of the calendar, and December 12,1918 2726 wile on duty thy shall receive $4 per diem, to be paid by the county. The county board of health shall have the i m and ry of helth interests of teir couty. They sall meet annually in the county town, and three members of the board ar authd to call a m of the bord wheneve in their opinon the public health interest of the county requirs it. They shal make such rule and regu- atious, pay sIch fee an salary, and impose much penaltie a in their judgment may be necy to protect and advance the public health: ProAd, That all expendi- tures shall be approved by the board of county comniaoners before being pd. The board of health shall meet on the first Monday of July, 1918, and thereafte on the second Monday of January in the odd year of the calendar, and elect either a county physician or a county health officer, who shall sve thereaer until the second Monday in January of the odd years of the cendar: Provide, That if ot county board of health of any county all Wfil to elect a county physician or county helth officer within two calendar months of the time set in this seton, the seetary of the State board of health dhall appoint a registered phycian of good ding in the sid county to the office of county physician, who sball srve the nde of the two yeas, and shall fix his compensation, to be paid by the sid county, in proportion to the compensation paid by other counties for like service, having in view the amount of tax collected by sid county. Suw. 10. Ruke of county board of health.-If any persn shl violate the rules and regulations made by the county boad of heth he sl be guilty of a miedemsnor, and fined not exceeding $5Q or imprisoed not exceeding 30 days Sac. 11. Duties of county physicians end health offier; penaltyfor nomperformance.- The duties of the county physiian shall be to make the medicolepl post mortem examinations for the coroner's inquests; to make em at of lunatics for comit- meat; to render profenional service to the sick inmates of the convict camp, jail, and county home, upon request of the superintendent or the kep e1-ths i-u ts, and to determine the nature of any particular disa, upon the reqst of thequrn- tine or deputy quarantine officer: Provided, That the county phyician skalihave the right to employ any other reguldy registered physician of his conty to perfom any or all of the duties pertaining to the jail, county home, or convict camp, whe in hiB judgment it is desiable to do so: Provided, howe, That the ternm under which such physician is employed by the county physician shall be approved by the bord of county commisioner. Te duties of the county heath officer shall be to devote his entire time to the county public helth work, and he shall perform the duties of the county physician, the duties of quarntine officer, and the following additional duties: He shall make a sanitary examination during the summer months of every public school building and grounds in the county, and no schol omttee or teacher shall make use of any school building or grounds until the county superintendent of health hall certify in writing that sid building and grounds have been inpected and found to bein a stisfactory sanitary condition withis four monthsof the date of the certificate. He shall e ne every school child that haspreviously been eamained by the teacher according to methods furnished said teache by the county superintendent of schools and reported to sad county superintendent of shoole as probably defective in the condition of its eyes, ears, nose, or throat, and he shl futher endeavor to have examined the feces of every child whm he sugpecta of having hookworm disease. He shall notify on blank forms and in accordance with instruction furnished by the State department of public instruction, every parent orguadian of a child aving any defect of the aforesaid organs, or hookworm dsea and behallsI ent to said parent or guardian the proper course of treament and urge that such treatment be procured. Be shall cooperate fully with the county board of ed , the county superintendent of schools, and the teachem in the public schools, to the end that chidren may be better informed in regard to the importance of health and the method of preventing disease. He shall, through the county pres, public addres, and in every available 2727 Dmeeber 12, 191S rw adavor to educat the p_e$e el his eouty to st a higber val en health and toadptarck publie cd p*ante mnesoma will tend to a grea on ife. Any violation of "s t n consitte a i meor, and sI subjt the deM~dant to a fine of not bl than $10 nor more than $50. fac. 12. A t f uisas.-Whenevw amd wherwr a nuisac shall exist wch in the eopnion of the conty physin or cuty alth offlcr i dagerou to te public health, it dsll be his duty to notify in writing the parties rpoble for ift coniuace, thet diameter of the nuisance and the meow of abaing it. Upn thii notificatlion, the parties ll proeeed to abate the nuimnee: Proid, h1AWr,that if the party notified shall mae oath or affination befor a judice of th peace f his or her inabflity t arr out the directions of the county physician or conty health officer, it dol be dome at the expense of the town, city, or county in *hich thOe offender liV.. In the latter e the limit of the expens chargmble to the city, town) or county sI not be mofe than $1,000 in any cae: Prvided, further, That nothing i this section hall be construed to give the county physicin Or conty health oficer the power to destroy or injure property without a due process of kwas now exists for the abatment of nuimances. Sao. 13. Nuia"; failwe to abat.-If any pern, fmn cerortion, or munici- palty rp Ile for the exsence and contince of a nuisance, after being duly notfied In writing by the couty physiian or county health officer to abate said nuisace, sha61WI to abate the same for 24 hour af such notice prescribed, he shall be guilty of a misdemenor, and hall be fined $2 a day as long as said nuisnce remains. Sac. 14. Median of municip" or health offier; proision for municipal hasth.--The authorities of any ety or tow, not already autorised in its charter, ar hereby authised to elect a munitipal physician or mnnicipal health officer when, in thei judgment, municipal helth would be improved therby, and to make such ato , pay seh fe and salies, and impose such penalties as in their judgment mBY be neceeary for the protection and the advancement of the public health. Sue. 15. Dis of th Municipal or Alth ofr; penaky for nonperforn- ance.-The duties of the municipl physician, within the jurisdiction of the town or city for which he is eleed, NWl be identical with those of the county physician for the conty, with the exception of the duties of the county physician pertaining to the jail, convict camp, and county home. The authorities of any city or town shall have the power to asign the duties of quarntine officer to the municipal physician or health officer, and in such cam the municipal health officer shall faithfully perform the duties of the quantine ofr as prescribed in sectiom 20 and 21 of this act, and shall be subject to the penaltie of the afors id sectionm for refusal or non- performance of duty. If the physician is employed to devote his entire time to the pubic health interests of his town or city, he shall be known as the municipal health officer, and he shall dischae al the duties pertaining to the public schools of his town or city which are ned n ction 12 to the county health officer, and such other duties as may be assigned him by the municipal board of health. Anyone violating any of the provisions of this section shall be guilty of a misdemeanor, and subject to a fine of not les than 810 nor more than $50. SBC. 16. Quarantine; quarantine offlcer.-All laws, with the exception of section 20 of this chapter, pertaining to the reporting, recording, and quaratining of disess, and all laws pertaining to didnfection, sall be faithfully enforced by the quarantine officer. The county physcan, eounty health officer, municipal physician or munici. pal health officer shall be elible to this office. The county board of health, on the first Monday of July, 1913, and thereafter on the second Monday of January in the odd Yer of the ciendar, shall eleet a quarantine officer for their county, and arrsn with such officer to accept and discharge the duties asigned in this chapter to such Deember 12, 1918 , 2728 official, and any other duties relating to the control of infctious dise which may -be assigned him by the county board of health. The quantine officer shall serve until the second Monday in January of the odd years of the calendar. Szo. 17. Rules and regulatio, for quarantne and disinfction; penalty.-Inland quaantine and disinfection shall be under the control of the quartine officer, who shall faithfully enforce the-rules and regulations governing quarantine and disnection asprescribed by-the local, county, ormunicipal board ofhealth: Provided, That nothing in this section shall interfere with the execution of section 20 of this chapter: Providd, That the quarantine of ports shall not be interfered with, but the officers of the local and State board shall render all aid in their power to quwantine officers in the discharge of their duties, upon the request of the latter: Providedfurther, That any child or other person may remain in custody and care of parents or family. The failure on the part of the quarantine officer to perform the duties imposed in this section shall be a misdemeanor, and he shall be punished for each offense by a fine of not les than $10 nor more than $50. Szc. 18. Penalty for refuad or negkct to cwry out quarantine.-If any person shall neglect or refuse to comply with the rules and regulations governing quarantine and disinfection, as prescribed by the local, county, or municipal board of health, he shall be deemed guilty of a misdemeanor, and upon conviction shall be fined not less than $5 nor more than $50; or imprisoned not less than 10 days nor more than 30 days, at the discretion of the court. In case the offender be stricken with the diease for which he is quarantinable, he shall be subject to the penalty on recovery, unlems in the opinion of the secretary of the State board of health it should be omitted. SiC. 19. The control of mallpoz.-On the appearance of a case of snallpox in any neighborhood, town, or city, the quarantine officer shall use all due diligence to wan the public of its existence and to notify the public of the proper means for preventing its spread; the said warning and notification to be according to the instructions of the State health officer. The board of health of any town, city, or county shall have authority to require children attending the public schools to present certificate of immunity from smaUpox, either through recent vaccination or previous attack of the disease. If any parent, guardian, school committee, principal, or teacher shall permit a child to violate such a requirement of the aforesaid authorities, he or she shall be guilty of a misdemeanor, and fined not less than $10 or more than $50. SEC. 20. Control ofyellowfever, plague, cholera, and typhusfever.-Any householder who knows that a person within his family or house, and any physician who suspects thst a person whom he is called to treat is sick with yellow fever, bubonic plague, Aiatic cholera, or typhus fever, shall immediately give notice thereof to the quarmtine officer, and the quarantine officer in turn shall immediately notify, by telegram, the secretary of the State board of bealth thereof. The secretary of the State board of health rhall personally asume control of the quarantine of the aforesaid disase and Shall promulgate such rules and regulations governing their control as he deems wise. Any one violating this section, or the rules and regulations made by the ecretary of the State board of health, as directed by this section, shall be, upon conviction, guilty of a misdemeanor, and fined not less than $50 nor more than $200, or imprisoned not less than 10 nor more than 60 days. SEC. 21. Precaution against contamination.-In the interest of the public health, every person, company, or municipal corporation or agency thereof selling water to the public for drinking and household purposes shall take every reasonable precaution to protect from contamination and assure the healthfulness of such water, and any provisions in any charters heretofore granted to such persons, companies, or municipal corporations in conflict with the provisions of this section are hereby repealed. The State board of health shall have the general oversight and care of all inland waters, and shall have from time to time, as it may deem advisble, cause eminations of said waters and their sources and surroundings to be made for the purpose of ascertaining 2729 December 12, 1915 wb ether the same are adapted for use as water supplies for drinking and other dometic purpoes, or are in a condition likely to impair the interest of the public or of persona lawfully using the same, or to imperil the public health. For the purpose aforesaid, it may employ such expert asistants as may be necessary. The said board shall make such resonable rules and regulations as in its judgment may be necessary to prevent contamination and to secure other purifications as may be required to safeguard the public health. Any individual, firm, corporation, or municipality, or the person or persons responsible for management of the water supply, failing to comply with said rules and regulations, shall be guilty of a misdemeanor, and upon conviction shall be fined or imprisoned, or both, at the discretion of the court. The State board of health shall from time to time consult with and advise the boards ofall State institutions, the authorities of cities and towns,corporations or firms already having or intending to introduce systems of water supply, drainage or sewerage, as to the most appropriate source of supply, the best practical method of assuring the purity thereof; or of disposing of their drainage or sewage, having regard to the present and prospective needs and interests of other cities, towns, corporations, or firms which may be affected thereby. All such boards of directors, authorities, corporations, and firnm are hereby required to give notice to said board of their intentions in the premises and to submit for its advice outlines of their proposed plans or schemes in relation to water supplies and disposal of sewage, and no contract shall be entered into by any State institution or town for the introduction of a system of water supply or sewage disposal until said advice shall have been received, considered, and approved by the said board. That for the purpose of carrying out the general provisions of this section, every municipal or private corporation, company, or individual supplying or authorized to supply water for drinking or other domestic purposes to the public shall file with the secretary of the State board of health, within 90 days after the receipt of notice from said secretary, certified plans and surveys, in duplicate, pertaining to the source from which the water is derived, the possible source of infections thereof, and the means in use for the purification thereof, in accordance with the directions to be furnished by the said secretary. Failure on the part of any individual, firm, corporation, or municipality to comply with this section shall be a misdemeanor, and upon conviction those responsible therefor shall be fined not less than $50 nor more than $100, at the discretion of the court. SEC. 22. Condmnation of lands.-All municipalities operating water systems and sewer systems, and all water companies operating under charter from the State or license from municipalities, which may maintain public water supplies, may acquire by condemnation such lands and rights in lands and water as are necessary for the successful operation and protection of their plants, said proceedings to be the same a prescribed by law for acquiring right of way by railroad companies. SEC. 23. May enter upon lands to lay pipes, etc.-For the purpose of providing water supplies, the directors or other lawful managers of any public institution of the State may enter upon the lands through which they desire to conduct their pipes for said purpose, and lay them underground, and they at all times shall have the right to enter upon said lands for the purpose of keeping the water line in repair and do all things to that end. SEC. 24. Compensation for land.-If damages shall be claimed for the use of such lands, and the parties can not agree as to the amount of compensation to be paid, they may proceed in the manner now provided by law for railroad companies to procure right of way. SEC. 25. Inspections of watersheds.-Any waterworks that derive their water from a surface supply shall have a quarterly sanitary inspection of the entire watershed, except in those cass where the supply is taken from large creeks or rivers that have a mImum daily flow of 10,000,000 gallons, in which case the inspection shall apply to the 15 miles of watershed above the waterworks intake. Such water companies 193 December 12, 918 2730 sha en 4obe mide asmnitaryinspetipon apatloulwloaityonmd watshed at les onee in every week, whenevr in the op4non ef the board of health of the ecy or town to 'weh the water is upplied, or, when tee is no uich lca boad of halth, in the opinion of the county superintendent of hedth or in the opiion -f the Stat board of health, there is specil reasn to apprehend th idnfetion of the water fromtiatparticular locality by the germ of typhoid fever or cholera. 'iMe inpection of the entire watershed as herein provided for shl include a particlar .xuuinoion Of eke prems of every inhabitd house on the waterhed, and, in pamg from house to hous, a general inspection for dead bodies of animal or accumuation of 11th. It is not intended that the temm "entire watershed shall include uninhabised fields and wooded ksets that e fre from supicion. The, inspection dll be nde by an employee of nd at the epmee of sid water company i accordance wih reasonable instnudens as to Beo, , and details, to be f by h saeretar of the Stte bowd of health. the said anitary inspector &all give in penn to the head Of a h ld on mid watershed or, in hisabsnce, to some memer of sid house hod, the ne y dcti for the pper i ca of his p . It all filh rbe te duty of id ispector to divert m ly redingon e wdta&ed adi itature on pertinent saniary subjects as may beoppliedkimby them iia hedth4effw.erbytdeseretwyotb*eateboalefhiedth. trepotinduplcteh of dl mdi inspectiew aWl be made o t to e ry of the Stt of hoal and theb acuacy to by the affdavit of the imspector, or au& dkeer or Pe as the sid srry1 may direct. One. hm.hA af ; pmaRldtforfaihe.-¶alre on t. pt af 4bose having In cagthe management of pube water supEs to enply with the law requinsaniryq ipection of watsr*edsshabe a idemanorad pdaelby a One of not lea than $2 nor more than 1,00, or by eat for aot l1= dIm 10 nor moe than 80 days: PEvid, Tfhe aid offiil does not prve to the on of the coufttds, in spiteof e beeft and dilieceon ip ho Wa preveted, drecty or indirecdly, by his s f doing his duty in this res t; in wich ase *e mid supeor offie shl be deenmd guilty of a demean d ed by. O e of not le than *0 nor more thn $P90, or by imp efor net S.. than one nor more than ix months. Szc. 27. Inapectora may enter upon, preMiN.-Each sanitary inspector her pro- viedforisauthorized and powered to enter upon any premie and into any build- iupon his respective wteed br the purpose of making the npect quired. . 28. R adet on -r t ob u* .-Every pemon resdingorown- ing pp on w red of a lake, pond, orsream r which a dini pply obaine l car out such r sonale intmuctions a may be f d h ithe matter hereinbefore set fo direct by the municipal healh officer or by the (tate boad of health. Anyone refAing or neglecting to comply with the requirements of *s pection sball be guilty of a misdemeanor and fied not les than PG nor more hn P9, o. imprisned for not lem than 10 nor more than 50 days. Sze. 29. Damage to water mupply.-If any person sHa defile, corrupt, or make impure any well, spring, drain, branch, brook, creek, or other source of pubtic water supply by collecting and depositing human excreta on the watershed, or depodting or alowing to remain the body of a dead animal on the watershed, orin any other manner, and i any pen shall destroy or injure any pipe, comductor of water, or other property pertaining to an aqueduct, or shall aid and abet therein, he sall be guilty of a misdemneanor. Szc. 50. Sewage not disdarged in.-No person, firm, corporation, or municipality shall flow or dischage sewwage above the Intake into any drain, brook, ereek, or river from which 4 public drinking-water supply is taken, unle* the same shall have been pawed hrough some well-known sgytem of sewage purification approved by the State board ofheath; and the continued flow and discharge of such sewage may be enjoined upon application of any person. 2731 a rM1, Ms a8 31. Ddig asew into casin e8smw.-If any pern, firm, or c a -tio, or eh ffiou id any m ality having a wwuege system in charge shall ht the i of the ihw reain!g o dislhig_ age to sre fm which public waIte 33 tkaken he s&Ha be deemed guilty of a mseenr Sae. 32. Ibtem, sic., not hawn seWagetem.-All schools, ha vil4, e, t,win or settlements which ae now located or may be her locted ob the shed of any public water upply, not provided with a saawuae sym, shail provide ad midnWn a onable system approved by the State board of health for el lecti d o f al accumulation of human excrement within their reeiv jurixsdic or osntl. Anyone i g or mglectig t comply with the require- mets o this fm shall be guilty of a ide anor d fined not 1e than 10 ac men the , or im ned for not lea ta 10 nm more than 90 days. sw 33. &at qtofgie; anayyses sfsr, spusn, Mood, er., - tienfor; ax agiiet water cpaees.- w the bette p tion of the public a to preweat te nsrd of c unicable teke*eshe m be est^habld a Stat bexa& tory tdhem to be undthe contolnd manaement of the State boa of hslth, ad it shl be the duty of te Stae boar of health to hav made in aich laIy_ ty at of m m al publi wae aspplimof tie Otate, of an waZ sold in botte or other package an of all optng water that e t and eAted n- an adjuact to any hoel, pak, or rairt for the mecommodat or enter. tainment of the public: P , That in the cu of spings I' ection With hotel, ps, rrts inter tently operated, tintiom of the water saU be med montWh during the peiod only that they ar open for the amaiodathn and e_r.- taiumnt of the pblic; but if upon e ea nof the waterof any ech sipring it dsh be foud to be infected or cotminated with inteWnl bal or other impu. ritwdUgvstohealth, examinassuebll be madeweeklyuntil itpuityand afey are shv. The board sha sW atue to be de e tis of w dld water when in the opinion of any cou suprine t of hs1*t or say physician there is reason to =so much walm of Weing e to he4h. The boad das likewie have made in this laborat*ry e itios of sutem in cases ofawsctd tubrcluis, or thoat axudaes in cas of sected diphi, of blood e of typid and lve, of fece in ea of sp d hookworm disese, an ch other stio the public health may reque. For the pport of the mid laboratoy the am of $6,000 annually is heeby appropriaed and an annual tsa of $64, payable quartery, by each ad evey water company, municipal, cppme and private, sling water to te people: Pvovkd, That the aid annal tax for watr fm sprin or welle sod in bottle or othewise shl be as follows: For or well the gis annua ales from which for the previous der year ele t $2,000 and more tn $1,600, $60; los than $1i600 and or than $1,000, $4; low than $1,000 and more than $600, $30; loe than $60 and more than $250, $20; and less than $250, $15; and for any spring maintained and treated an adjunct to any hotel, park, or resort for the accommodation and enter- tainment of the public, $16, and an additional tax for water sold in bottle or other package from sid spring in accordance with the above schedule. Every corporation, firm, or person sellingwate in the maner set forth in this provis shal file with the treaser of the State board of health, within 60 days after the pa_ge of this act and annually thereafter in the month of January, an affidavit as to the por amountreceived fromaleofwaterlerthe previos calendaryew, and upon thisaffidavit the tax for the current year shall be based. Failure to so file raid affidavit within the time prescibed shall subjwt the mid c tio m, or perso a failing to file mid affidavit to double the tax for the curent yer. Fau to trnsait mmple witin five days after receipt of steflized bottle or contain om the lboratoy ad hygiene, shall be a mi ano, and upon conviction ball subject the ddinquent to a fne of $25. Tnnsportation charge, by mail, shall be paid by the under; by exprou,by the laboratory. When deemed advisable, the said laboratory of hygiene shall analyze December 12,1918 2732 amples purhaed by it in the open market, in lieu of those sent direct from the spring. The said tax hall be collected quarterly by the sheriff as other taxes, and shall be paid by the said sheniff directly to the trearer of the State board of health. The printing and stationery necesary for the laboratory shall be furnished upon requisition upon the State printer. Any person, firm, or corporation not a citizen of the State of North Carolina who shall sel or offer for sule any water in bottle or other package for consumption by the people of the State of North Carolina shall obtain a licene from the treasurer of the State board of health, and shall pay for said license the sum of $64 per annum, or les amount equal to the tax paid by springs of the same clas within the State, upon compliance with the conditions applying to them, payable in advance: Prvided, That-satifactory evidence of purity furnished by the State laboratory of other States agreeing to reciprocate in this matter with this State shall be accepted in lieu of the said license tax. If water sold by any person, firm, corporation, or municipality shall be discovered by three succesive analyses made by the State laboratory of hygiene to be dangerous to the public health, publication of that fact hall be made in the monthly Bulletin of the State Board of Health. The result of said analyses all be immediately forwarded by mail to the person, firm, corporation, or municipality lling the water so analyzed. When upon subsequent analyses the water shall be found no longer dangerous to health, a certificate thereof hall be furnished the person, firm, corporation, or municipality offering the said water for sale, and publication of the fact sall be made in the said monthly bulletin: Provided, That this act shall not apply to the therapeutic waters so medicated as to render them sterile, the question of their sterility to be decided by the director of the State laboratory of hygiene. SEc. 34. Duties of soitor to proseute infringements.-That for every violation of sections 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, and 37 it shall be the duty of the solicitors of the several judicial districts, upon the complaint of the board of health, or any of its officers, or of any individual injured or likely to be injured, to institute crimnal action against the person, firm, corporation, or municipality charged with such violation in their respective districts, and prosecute the ame. SEC. 35. Annual appropriation.-For carrying out the provisions of this act as to the duties of the board of health $26,500, or so much thereof as may be necessary, is hereby anually appropriated, to be paid by the State auditor on requisition, to be signed by the secretary and president of the State,board of health, the same to be apportioned as follows: Fourthousand dollars to the State laboratory of hygiene, $8,000 to the campaign against the hookworm disease, and $14,500 to the executive officer. of the State board of health, and the printing and stationery necessary for the board to be furnished upon requisition upon the State printer: Provided, That $1,000 of this appropriation be used annually by the State board of health to arrnge for a supply of diphtheria antitoxin, which shall be available to the citizens of the State at contract price. A yearly statement shall be made to the govemor of all money received and expended in pursuance of this act. SEC. 36. Contingentfund.-A contingent fund of $5,000 is appropriated, subject to the auditor's warrant, upon the recommendation of the govemor, to be expended in pursuance of the provisions of this act, when rendered necesary by the visitation of cholera or any other pestilential disease. SEC. 37. That all laws and clauses of laws in conflict with this act are hereby repealed. Vaceination. (Chap. 181, Act Mar. 12, 1913.) (Section 4451, Revised Laws of 1905, was amended to read as follows:) 4451. Vaccination.-On the appearnce of a case of smallpox in any neighborhood due wang of the existence of the disease shall be given,-and all persons not able to pay shall be vaccinated free of charge by the county physician or health officer or by the'municipal physician or health officer, and the county physician or health officer 2733 December 12,1918 sha vaccinate every perso admitted into a public institution, jail, or county home as soon as practicable, unles he is satisfied, upon emiation, that the person is already succesfully vaccinated; the money for vaccine to be furnished by county commissioners. The board of health of any city, town, or county may make such regulations and provisions for the vaccination of the inhabitants of their city, town, or county, and impose such penalties as they may deem necessary to protect public health. WASHINGTON. BirtU and Death-Registration of. (Chap. 163, Act Mar. 22, 1913.) ScTON 1. That section 5424 of Remington & Balinger's Annotated Codes and statutes of Wahington be amended to read as follows: "Sw. 5424. That for the purpose of this act the State shall be divided into registration districts as follows: Each city and incorporated town shall constitute a primwy registration district, and each county, exclusive of the portion included within cities and incorporated towns, sball be subdivided by the State registrar into diticts in such manner as may appear necesary for the convenience of the people, and each such district shall constitute a primary registation district, and each primay regi tration district hall be numbered by the State registrar." Sic. 2. That section 5425 of Remington & Ballinger's Codes and Statutes of Washington be amended to read as follows: "Sic. 5425. The health officer of each city and incorporated town shall be the local trar in and for such primy registration ditict and shall perfoin All the duties of local regirar as hereinafter provided. The State registrar shall appoint a suitable person to be local registrar in and for each district not included in cities and incorporated towns, who shall hold such position during the pleasure of the State registrar and shall perform all the duties of local registrar, as hereinafter provided. Each local registrar shall immediately appoint in writing a deputy who shall be authorized to act in his stead in case of absence, death, illness, or disability." Szc. S. That section 5441 of Remington & Ballinger's Codes and Statutes of Washington be amended to read as follows: "Sic. 5441. That each local regstrr shall be paid the sum of 25 cents for each birth and death certificate properly and completely made out and registered with him and by him returned to the State registrar on or before the 5th day of the following month, which sum hall cover and include the making out of the burial permit and copy of the certificate to be filed and preserved in his office. And in cae no births or deaths were registered during any month, the local registrar shall be paid the sum of 25 cents for each report to that effect, properly made out in accordance with the directions of the State registrar: Provided, That all local registra who receive regular compensation as health officers all not be entitled to the fee of 25 cents, above mentioned, but the duties of the local registrar shall be considered as a part of their duty as local health officer. All accounts payable to local regists under the pro- vions of this act shall be paid by the rasurer or other lawful officer, out of the funds of the coanty or city, upon warrants drawn by the county auditor, or other proper local officer of such county or city, which warnt shall specify the number of certificates, properly rWistered and reports promptly returned where no birth or deaths are regisered: Provied, however, That no warrsnt shall be isued to any local registrar until he shall present a certificate from the State rgistar stating the number of certificates and reports of no birth and no deaths properly returned to the State gar, hich certificates the State s ar all isue during the months of January, April, July, and October of each year, after he shall have received the certificates and reports for the months next preceding." Sic. 4. This act shall take effect January 1, 1914. Deenber 1Z 1*13 2734

Se BWd of I Povers ad D1tes (Act Feb. 20* 1913.) (An amendment and reenactment of certa setion. of chapter 150 of the Code of 166 and an addition of new section.) S oCTIoN 1. There sall be a State board of health in this Stte, consiting of two physicians residing in each of the congressonal districts thereof, and, until such a time as a bill redistricting the State is pased by the legislature, two members at large. Said physicias. all be graduates of reputable medical schools, and shall have prac- ticed iaedicine for not lems than six years continuously before their appointment, and no two memboe shl bohe ate of the ame eounty wen apointed; any member of the board moving into a county aslady the residAnee of anQteir member Ill vacte his offtbe The goverr oh, in the month of May, in the yea 1913, appoint said pkyaiciaan, who shall be divided into two clasm4 each clam co g o one phyicia from each c grIel districtt and until suck a time so a redistricting bill i paed, one at age. The term of oice ot eack clashall begi on the first day of June, in the year of thir ppoitment. The tra of office for the first cl shall continue two year and of the second clam four years, and until thLeir successrs are appointed and qualified. When the term of office of either clasn, or of any of said physicians, expires the govrnor shl appoint their succeors for the succeeding term. The governor may in like manner appoint physician to fill any vacancy that may ocur in the board, but any appointment to fill a vacancy s be for the unexpired tm. The term of officeof the members of the State board of health now in office shall be ontinued by the govemor for the term of their appointment, but at any time uponi a rearangement of ditrict lines, or the formation of a naew district in which two or meoe of the mmbers live whose term of office expea at the sme time, the governor shall have authority to remove, appoint, or regulate the officesin conmity to thisact. Sw. 3. Said board shall on a day tobe fixed by them in every two yrs elect from their own sumlwr a presdent who shall hold h office for the term of two years, and unti his succemr has been elected and entered upon his duties The board shall also have a secretary named by the gvernoor who shall be one of their number, who hall be ex officia State health mmoae and as such exise all the powers confer upon him by this ceapte, cary out all rules regulation, and ordes of the hord, and exercise al other power pertaining toof e of like kind. Said sowertary all be, hien appointed, a phyician in active practie; but during the term of his dito the screiary shall dwots his whele time to the duties of te office. Th said bowrd sall beea oprsti by the nsame and style of the "Stat Boar4d eth of West Viginia," and bave and moe a. coomon ml, and as sk corporatioa may sue d be med-, eatmot A be esricted witi, plead and be impleadd wih, to the ez_mt f. the powers ceaferre& upon tem by hi chapter. Saii bor my make aapt allns rulesZregulatieasoand y-law not i_'ccnaint with the laws or the Conefitutiw o. %te Stae or tb United Stt, to enable it ti prfam its duties and ranct its bumne in ata te provriom of thi. c&apber A maority o tIe .oari l contute a quaom ior the nction of binm rar sal oal SR niastinga ofthe bosd up= ordwe of the ed ow wittea reuest ofsay three munbes tIrerw m The mcro6my shla be e recrdimg oicer of the board and is addition to *e qte du"i. ibnd thitchapSr hwahall rooesudM al conunicatiems from any meor of th Ste bad sd othw epstabla physiamis mnd hem offiers of th Stat, and ive the aia"ioand atvkoe a=y be nitP_ fm time I. timeaSto measuraef n.n twothomattw eonnortd public heat and safety. He shall be the custodian of all bookeaud pawMD itument.sorappiances, belonging to the State board of health or thiA may be invsted in his cam. He shall also do and perform such other duties as the State board may lawfully direct, and in 2735 December 12, 1918

ewe of the ee e m end infectios ad cntg disas or ether unusual aickne he shall, upon the reuest of the cal heah officer, vit tIe locat and advis sueh halth officers asthe SXta boad may drectad aid in the adeptien of such regubtion for its w mi as may sem bes. He shl annualy report to the guvrnr, on or beore the firS &y of January, each year's investigations, scoreuies, a i oftheboad, which shall be printed and disribated asooose p le _eaftr in tbo ammonan a other publk _beuments of the State, neept that the governor may ase said reprt to be Pired and dirlibuted anlly. hca D. Th bmi of healt is ivesed with all the ught and caged with all the duties pertenins te aa of lke characew, and shall be the soe advier of the Statsin all questha. involig the protection of th public health within its fimit,and s take a the intert. of the lift ad health of the inhabi- lonts of te Sta, an shll make or cause to be made sanibty investitions ad inquiie respecting the emmu of dse, e cilly of epidemics, e c, and the mesm of prevention, the mores of mortality, and the effects of localities, employ ments, habits, and circu ac of life on the public health. They shl ipect and examine the fbod, drink, and drug offered for ale or public consumption, in such manner as they shall deem necemry, either in pernso or by agents or employees, and shall report all violations of the laws of this State relating to pure food, drink, and drugs, to the proecting attorney of the county in which such violation may occur, and lay before such prosecuting attorney the evidence in their knowledge of such violationw. They shall also investigate the causes of disease occurring among the stock or domestic anima.i the State; the methods of remedying the same, and shal gather information in respect to the matters embraced in this section and kindred subjects, for the diffusion amoug the people. They shall ale into and advise as to the supply, aine, and swerage of cities, tow , and villages, the ventiation and wanring of public a, churchs schoolhous, worklshops, prisos, and all other public insitutions; the ventilation of coal mines and how to ea p ptly cidet rulting hfm poionous When they belie" that then is a probabiity that Y infectious oreontn.ous diseaF will invade the State from any other State, itshaRl be their duty to takesuch action and to adopt and enforce each rle as theymy, in thewx ise oftherdiscretion, deem eficient for preventing the intedaction and spead of dissediords .Tbetter accomplish such objects, the Stateand county boars an empowered to. tablish d stictly tin qua antine at esch phceas- ym deem proper, and may adopt rules and regulations to obstruct and prevent the introduction or spread of contagiuor i afs disease to or wfhimhiia 8t, sad shl hau power to enforc thens r atinby detention an awstt if n y .The may haxe power to enter in"oany town, city, or cor- poratha, hdlfact_ry4 mim , or any plac whatsoever within e limits otdh State km epwurpsofi th* sary and hygieni conditions, aDd a. at their d t charge any epidemic or e cditio ag withi the limitn of the Stae, and enforce suih lon a they may pribe. Bu all expenme km guad, or othe eme. icurred in ctlig y edec oepidiem cni s

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